A psychoeducational program for weight loss in patients who have experienced weight gain during antipsychotic treatment with olanzapine

Department of Psychiatry, School of Medicine, University of Pisa, Pisa, Italy.
Pharmacopsychiatry (Impact Factor: 2.17). 01/2008; 41(1):17-23. DOI: 10.1055/s-2007-992148
Source: PubMed

ABSTRACT The aim of this study was to evaluate the efficacy of a psychoeducational program (PEP) for weight control in patients who had experienced an increase of body weight during treatment with olanzapine.
Eligible patients were randomised to the PEP (Group 1) or to no intervention (Group 2) and continued on olanzapine. After 12 weeks, the PEP was also started in Group 2 and continued in Group 1, up to week 24. Body weight was measured every month. Other measures included quality of life, and change in plasma glucose and lipids levels.
Patients in Group 1 (n=15) had a mean weight loss of 3.6 kg at week 12 and 4.5 kg at week 24 (p<0.01 at both times, p<0.01 between groups at week 12), while those in Group 2 (n=18) had no changes at week 12 and a significant weight loss at week 24 (-3.6 kg from week 12, p<0.01). Changes of BMI paralleled those of body weight. Quality of life (Q-LES-Q-SF categorisation) and functioning (GAF) significantly improved in the total population at endpoint (p<0.01). No significant changes were observed in fasting glucose and lipid profile, while insulin levels significantly decreased from baseline to endpoint in both groups (p<0.05). HOMA index and hepatic insulin sensitivity improved, too.
Patients with increased BMI during treatment with olanzapine experienced significant weight and BMI loss following a structured psychoeducational program.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There is a high prevalence of overweight and obesity in persons with severe mental disorders and this has serious implications on the short and long term health outcomes of these patients. The aim of this review was to evaluate the effectiveness of lifestyle interventions targeting physical activity and eating habits in persons with severe mental disorders. Special attention was given if any of the included studies in the review also examined the cost-effectiveness of these health promotion interventions. A systematic search through the electronic databases Medline, Web of Science, CINAHL and Cohrane Library was conducted, and by hand-searching the reference lists of the retrieved articles from the electronic databases. Studies were included if they examined effectiveness and/or cost-effectiveness of lifestyle interventions targeting physical activity and eating habits in persons with severe mental disorders, with primary outcome changes in Body Mass Index and body weight. Fourteen studies met the inclusion criteria. Weight loss and Body Mass Index decrease were observed in intervention groups in 11 studies. The difference in weight change between intervention and control groups was statistically significant in nine studies. Differences in mean Body Mass Index between intervention and control groups were statistically significant in eight studies. Five studies reported improvements in quality of life and general health. In none of the studies cost-effectiveness of lifestyle interventions was examined. Further research on both effectiveness and cost-effectiveness of lifestyle interventions targeting physical activity and eating habits in persons with severe mental disorders is required to assist in the development of new health promotion interventions in this population.
    International Journal of Behavioral Nutrition and Physical Activity 04/2011; 8:28. DOI:10.1186/1479-5868-8-28 · 3.68 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Identification of systems with very slowly and irregularly sampled output data is considered. While the input is sampled uniformly and frequently enough, the output sampling time is assumed very long, say, much longer than the dominant time constants. The output sampling may be irregular. Dual-rate system with slow output samples is a special case of the problem studied here. Model structures for the identification of the fast rate models will be proposed. Output error method is proposed and motivated for parameter estimation. Consistence of the estimate is established and covariance expression of the parameters is derived. Simulation studies will be used to illustrate the method. The developed identification method can also be used in other fields where measurement delay is a major problem.
    Decision and Control, 2005 and 2005 European Control Conference. CDC-ECC '05. 44th IEEE Conference on; 01/2006
  • [Show abstract] [Hide abstract]
    ABSTRACT: Obesity is one of the most common physical health problems among patients with severe and persistent mental illnesses, such as schizophrenia. Multifactorial in origin, obesity can be attributed to an unhealthy lifestyle as well as the effects of psychotropic medications such as second-generation antipsychotics. Excess body weight increases the risk for many medical problems, including type 2 diabetes mellitus, coronary heart disease, osteoarthritis, hypertension, and gallbladder disease. A PubMed search revealed 403 English-language citations to the query "schizophrenia" AND "obesity" and 469 citations to the query "obesity" AND "antipsychotics." The evidence is that different antipsychotics have different propensities for weight gain, and that children, adolescents, and fi rst-episode patients are at higher risk for weight gain associated with antipsychotic treatment. Monitoring body weight early in treatment will help predict those at high risk for substantial weight gain. Switching antipsychotic medication may or may not be clinically feasible, but can lead to a reduction in body weight. Lifestyle therapies and other nonpharmacological interventions have been shown to be effective in controlled clinical trials, but the evidence base for adjunctive medication strategies such as with orlistat, sibutramine, amantadine, nizatidine, metformin, topiramate, and others, is conflicting. At the very least, a "small-steps approach" to managing weight should be offered to all patients who are overweight or obese.
    Postgraduate Medicine 07/2008; 120(2):18-33. DOI:10.3810/pgm.2008.07.1786 · 1.54 Impact Factor