TOS Response to NEJM Mental Illness & Obesity Study, March 21, 2013

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The Obesity Society Response to “A Behavior Weight-Loss Intervention in Persons with Serious Mental Illness” in the New England Journal of Medicine



Martin Binks, PhD, The Obesity Society, Development Committee Chair, member of the Obesity Week™ Board of Managers


The Daumit study shows promise for the often underserved population impacted by both severe mental illness and obesity. If we can successfully integrate weight loss interventions into the standard treatment environment for this population, we are one step closer to improving the quality of life for a group of people who face an even steeper challenge when it comes to weight loss.


People with major mental illness have prevalence rates of obesity that are nearly twice that of the general population and mortality rates two-to-three times higher, yet they are typically excluded from behavioral weight-loss trials and surgical interventions. Furthermore, they can face additional cognitive and emotional challenges that interfere with many of the things we often ask people to do to manage weight, such as planning and monitoring meals and exercise, and reducing emotionally triggered eating. They also face the challenge that comes with taking psychiatric medications that often lead to weight gain.


It is particularly encouraging that the study was designed with these needs in mind and was delivered in a primary mental health setting. Teaching mental health providers tailored behavioral weight loss strategies and ways to integrate them into the care setting can help us reach more people and potentially have a significant impact on the prevalence of obesity among people affected by mental illness.


The primary limitation in the study is the control group, which restricts a full understanding of whether the aspects of the intervention that are tailored toward individuals with mental health conditions (e.g., bipolar disorder, schizophrenia, major depression, etc.) were uniquely effective or if simply providing an intensive, general lifestyle intervention alone would work equally well. Regardless, we look forward to seeing the progression of this line of research to include a more impactful control group where all study participants are provided the intensive general counseling, and structured exercise and nutrition guidance.


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About The Obesity Society

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