A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

Obesity is a major public health concern and studies have shown that people with serious mental illness (SMI) may be at higher risk of being overweight or obese than people without SMI. Being overweight or obese can put people at risk for cardiovascular disease, diabetes, and other conditions. Wellness programs that promote healthy eating and exercise can help reduce these risks for people with SMI. A recent NIDILRR-funded study evaluated a program designed to teach people with SMI about nutrition and wellness to see if it could help them make important behavioral changes to lose weight and live a healthier life. 

Researchers from the Rehabilitation Research and Training Center on Psychiatric Disability and Co-Occurring Medical Conditions tested Nutrition and Exercise for Wellness and Recovery (NEW-R), an 8-week weight loss program focusing on behavior changes in nutrition and physical activity. The NEW-R program consists of weekly sessions that include education about healthy living, opportunities for active learning, and a period of moderate exercise. The program encourages participants to engage purposefully in weight management activities, from setting daily and weekly goals to actively planning daily behaviors that can impact weight. The program is designed to be easily adopted and used in a variety of settings and includes in-depth leader and participant manuals. 

For this study, researchers recruited a small group of 16 individuals from a community mental health agency. At the start of the program, all participants had a body-mass index (BMI) higher than 25. BMI is a measure of body fat based on height and weight. A BMI of 25 or more is considered overweight; a BMI of 30 or more is considered obese or extremely obese. Participants met once a week for 8 weeks in 2-hour sessions led by an occupational therapist or occupational therapy graduate student. Each session included an interactive lesson on nutrition and physical activity, a 20-minute moderate-intensity workout, and a healthy meal. Participants also received materials to help build positive behaviors such as elastic exercise bands and a workbook that included recipes and guidelines for healthy eating out, along with a bag of healthy groceries as an incentive to participate in follow-ups.

To determine the effectiveness of the program, researchers looked at changes in participants’ weight over 6 months as well as their knowledge about healthy eating and exercise. When the program started, the average weight of the participants was 229.2 pounds. At the end of the 8-week program, the average weight was 226.2 pounds. The results were more encouraging at 6 months: The average weight loss was 10 pounds or 3.6 percent of total body weight, and several participants lost more than 5 percent of their body weight. Participants were tested on their knowledge regarding healthy eating and exercise at the beginning and end of the program and overall knowledge scores increased by 7 percent.

According to the authors, NEW-R shows promise for promoting weight loss and increasing knowledge about nutrition and physical activity for people with SMI. The authors found that the average weight loss of 10 pounds or 3.6 percent of body weight experienced by participants in this study was greater than weight loss seen in other studies of weight loss programs for people with serious mental illness. However, the authors noted that this was a small study of volunteers who may have been motivated to lose weight. Also, there was no control group in this study, so they could not say whether the NEW-R program was more effective than other weight loss programs or no program at all. The researchers are currently preparing to conduct a randomized controlled trial comparing NEW-R to a control condition, and that study will examine additional wellness outcomes such as activity levels and quality of life.

To Learn More:

The NEW-R curriculum is available free of charge from the project. Participant and leader manuals may be downloaded from http://www.cmhsrp.uic.edu/health/weight-wellbeing.asp

The NIDILRR-funded Guidelines, Recommendations, and Adaptations Including Disability (GRAIDs) project features adaptations to community-based obesity reduction strategies for youth and young adults with cognitive and physical disabilities: http://reduceobesity.org/strategies.php

The National Center on Physical Activity and Disability offers a wealth of resources on sports and physical fitness for every ability: http://www.nchpad.org

To Learn More about this Study:

Brown, C., Read, H., Stanton, M., Zeeb, M., Jonikas, J.A., and Cook, J.A. (2015) A pilot study of the Nutrition and Exercise for Wellness and Recovery (NEW-R): A weight loss program for individuals with serious mental illnesses. Psychiatric Rehabilitation Journal, 38(4), 371-373. This article is available from the NARIC collection under Accession Number J72942.

This project is also supported by the Substance Abuse and Mental Health Services Administration (SAMHSA).