A Diet and Fitness Program Similarly Affects Weight Reduction in Schizophrenia Patients Treated with Typical or Atypical Medications

Abstract

Introduction: Schizophrenia patients, receiving new generation antipsychotics, many times suffer from obesity sometimes leading to metabolic syndrome. Diet and fitness programs which reduce weight should be combined in the treatment plan of these patients. This study evaluated patients’ adherence and the effect of a diet and fitness program in schizophrenia patients treated with typical vs. atypical antipsychotics.

Methods: 106 stabilized schizophrenia patients participated in a 9-months diet and fitness program, receiving their own menu and a personal workout plan.

Results: 60 patients (57%), 27.8±4.8y age, participated in the program for at least one month, i. e., adherent participants, with 4.0±2 months participation average. Months of participation were correlated with weight loss (r=−0.417; p=0.002). Throughout the study patients lost 3.34±1.2 kg in average: 85.95±14.66 at baseline and 82.61±13.78 at the end of program (t=4.969; p<0.001). No association was found between specific types or dose of medication and weight loss (F=0.437, p=0.85).

Discussion: Patients with schizophrenia are capable of adhering to a diet and fitness program and successfully lose weight, regardless to taking typical or atypical medications.

Key words

schizophrenia - diet - physical fitness - antipsychotics

• References

• 1 Andersen AH, Vinther A, Poulsen LL et al. A modified exercise protocol may promote continuance of exercise after the intervention in lung cancer patients – a pragmatic uncontrolled trial. Support Care Cancer 2013; 21: 2247-2253
• 2 Haklai Z, Goldberger N, Stein N et al. The mortality risk among persons with psychiatric hospitalizations. Isr J Psychiatry Relat Sci 2011; 48: 230-239
• 3 Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis 2006; 3: A42
• 4 Laursen TM, Munk-Olsen T, Vestergaard M. Life expectancy and cardiovascular mortality in persons with schizophrenia. Curr Opin Psychiatry 2012; 25: 83-88
• 5 Wang Y, Liang H, Tussing L et al. Obesity and related risk factors among low socio-economic status minority students in Chicago. Public Health Nutr 2007; 10: 927-938
• 6 Allison DB, Casey DE. Antipsychotic-induced weight gain: a review of the literature. J Clin Psychiatry 2001; 62 (Suppl. 07) 22-31
• 7 Dipasquale S, Pariante CM, Dazzan P et al. The dietary pattern of patients with schizophrenia: a systematic review. J Psychiatr Res 2013; 47: 197-207
• 8 Kemp DE. Managing the side effects associated with commonly used treatments for bipolar depression. J Affect Disord 2014; 169 (Suppl. 01) S34-S44
• 9 McEvoy JP, Meyer JM, Goff DC et al. Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 2005; 80: 19-32
• 10 Newcomer JW. Antipsychotic medications: metabolic and cardiovascular risk. J Clin Psychiatry 2007; 68 (Suppl. 04) 8-13
• 11 Henderson DC. Weight gain with atypical antipsychotics: evidence and insights. J Clin Psychiatry 2007; 68 (Suppl. 12) 18-26
• 12 Jakicic JM, Davis KK. Obesity and physical activity. Psychiatr Clin North Am 2011; 34: 829-840
• 13 Vancampfort D, Knapen J, Probst M et al. A systematic review of correlates of physical activity in patients with schizophrenia. Acta Psychiatr Scand 2012; 125: 352-362
• 14 Zapico AG, Benito PJ, Gonzalez-Gross M et al. Nutrition and physical activity programs for obesity treatment (PRONAF study): methodological approach of the project. BMC Public Health 2012; 12: 1100
• 15 Ellis N, Crone D, Davey R et al. Exercise interventions as an adjunct therapy for psychosis: a critical review. Br J Clin Psychol 2007; 46: 95-111
• 16 De Hert M, Schreurs V, Vancampfort D et al. Metabolic syndrome in people with schizophrenia: a review. World Psychiatry 2009; 8: 15-22
• 17 Faulkner G, Cohn T, Remington G. Validation of a physical activity assessment tool for individuals with schizophrenia. Schizophr Res 2006; 82: 225-231
• 18 Daumit GL, Dickerson FB, Wang NY et al. A behavioral weight-loss intervention in persons with serious mental illness. N Engl J Med 2013; 368: 1594-1602
• 19 Cabassa LJ, Ezell JM, Lewis-Fernandez R. Lifestyle interventions for adults with serious mental illness: a systematic literature review. Psychiatr Serv 2010; 61: 774-782
• 20 Bartels SJ, Pratt SI, Aschbrenner KA et al. Clinically significant improved fitness and weight loss among overweight persons with serious mental illness. Psychiatr Serv 2013; 64: 729-736
• 21 Faulkner G, Cohn T, Remington G. Interventions to reduce weight gain in schizophrenia. Cochrane Database Syst Rev 2007; CD005148
• 22 Papanastasiou E. Interventions for the metabolic syndrome in schizophrenia: a review. Ther Adv Endocrinol Metab 2012; 3: 141-162
• 23 Patel MX, Arista IA, Taylor M et al. How to compare doses of different antipsychotics: a systematic review of methods. Schizophr Res 2013; 149: 141-148
• 24 Woods SW. Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry 2003; 64: 663-667
• 25 Agerbo E, Byrne M, Eaton WW et al. Marital and labor market status in the long run in schizophrenia. Arch Gen Psychiatry 2004; 61: 28-33
• 26 Wu MK, Huang CY, Liou YJ et al. Glucose-insulin homeostasis, lipid profiles and GH-IGF-IGFBP axis in clozapine-treated schizophrenic obesity versus non-psychiatric obesity. Int J Obes (Lond) 2008; 32: 436-442
• 27 McKibbin CL, Patterson TL, Norman G et al. A lifestyle intervention for older schizophrenia patients with diabetes mellitus: a randomized controlled trial. Schizophr Res 2006; 86: 36-44
• 28 Bouchard DR, Soucy L, Senechal M et al. Impact of resistance training with or without caloric restriction on physical capacity in obese older women. Menopause 2009; 16: 66-72
• 29 Donnelly JE, Blair SN, Jakicic JM et al. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2009; 41: 459-471
• 30 Del Corral P, Chandler-Laney PC, Casazza K et al. Effect of dietary adherence with or without exercise on weight loss: a mechanistic approach to a global problem. J Clin Endocrinol Metab 2009; 94: 1602-1607
• 31 Postrach E, Aspalter R, Elbelt U et al. Determinants of successful weight loss after using a commercial web-based weight reduction program for six months: cohort study. J Med Internet Res 2013; 15: e219
• 32 Millward DJ, Truby H, Fox KR et al. Sex differences in the composition of weight gain and loss in overweight and obese adults. Br J Nutr 2013; 1-11
• 33 Andersen JR, Aadland E, Nilsen RM et al. Predictors of weight loss are different in men and women after sleeve gastrectomy. Obes Surg 2013;