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The Effects of Lifestyle Interventions on (Long-Term) Weight Management, Cardiometabolic Risk and Depressive Symptoms in People with Psychotic Disorders: A Meta-Analysis
Open accessAbstract
AIMS: The aim of this study was to estimate the effects of lifestyle interventions on bodyweight and other cardiometabolic risk factors in people with psychotic disorders. Additionally, the long-term effects on body weight and the effects on depressive symptoms were examined. MATERIAL AND METHODS: We searched four databases for randomized controlled trials (RCTs) that compared lifestyle interventions to control conditions in patients with psychotic disorders. Lifestyle interventions were aimed at weight loss or weight gain prevention, and the study outcomes included bodyweight or metabolic parameters. RESULTS: The search resulted in 25 RCTs -only 4 were considered high quality- showing an overall effect of lifestyle interventions on bodyweight (effect size (ES) = -0.63, p<0.0001). Lifestyle interventions were effective in both weight loss (ES = -0.52, p<0.0001) and weight-gain-prevention (ES = -0.84, p = 0.0002). There were significant long-term effects, two to six months post-intervention, for both weight-gain-prevention interventions (ES = -0.85, p = 0.0002) and weight loss studies (ES = -0.46, p = 0.02). Up to ten studies reported on cardiometabolic risk factors and showed that lifestyle interventions led to significant improvements in waist circumference, triglycerides, fasting glucose and insulin. No significant effects were found for blood pressure and cholesterol levels. Four studies reported on depressive symptoms and showed a significant effect (ES = -0.95, p = 0.05). CONCLUSION: Lifestyle interventions are effective in treating and preventing obesity, and in reducing cardiometabolic risk factors. However, the quality of the studies leaves much to be desired.
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“Interventions with long-term follow-up are also warranted, since there are no reasons to believe that changes in metabolic risk factors occur faster in patients with severe mental disorders than the general population 18 .”
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“Weight reduction is the most used outcome [46][47][48][49][50][51][52][53][54][55] and the evidence is reported to be favourable 17 , although long-term trials are missing 18 .”
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“…the research group (JB, FJ, EC, MP), which led to the exclusion of seven more studies: in five of these studies the participants were not randomly assigned to the experimental or the control group [38–42], and the two other studies did not meet the criteria of a lifestyle intervention [43, 44].”
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Sorted by citations
Garvey, W. T., Mechanick, J. I., Brett, E. M., Garber, A. J., Hurley, D. L., Jastreboff, A. M., Nadolsky, K., Pessah-Pollack, R., & Plodkowski, R. (2016) · Endocrine Practice · doi:10.4158/ep161365.gl · Cited by 1,914
Antipsychotic-associated weight gain: management strategies and impact on treatment adherence
Dayabandara, M., Hanwella, R., Ratnatunga, S. S., Seneviratne, S., Suraweera, C. U., & de Silva, V. A. (2017) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s113099 · Cited by 399
“There was no significant effect on blood pressure or cholesterol.(55) An RCT comparing an early behavioral intervention with routine care in preventing AIWG in drug-naive first-episode psychosis patients found that the behavioral intervention group gained significantly less weight (mean =4.”
BackgroundCooper, S. J., Reynolds, G. P., order):, W. E. C.-A. (. A., Barnes, T., England, E., Haddad, P., Heald, A., Holt, R., Lingford-Hughes, A., Osborn, D., et al. (2016) · Journal of Psychopharmacology · doi:10.1177/0269881116645254 · Cited by 292
“An increasing number of studies have demonstrated the effectiveness of lifestyle intervention for people receiving antipsychotic medication (Bruins et al., 2014; Caemmerer et al., 2012).”
BackgroundVancampfort, D., Firth, J., Correll, C. U., Solmi, M., Siskind, D., De Hert, M., Carney, R., Koyanagi, A., Carvalho, A. F., Gaughran, F., et al. (2019) · World Psychiatry · doi:10.1002/wps.20614 · Cited by 227
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Metadata
- Authors
- Bruins, J., Jörg, F., Bruggeman, R., Slooff, C., Corpeleijn, E., & Pijnenborg, M.
- Affiliations
- University Medical Center Groningen (NL)
- Corresponding author
- Bruins, Jojanneke
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-12-04
- Volume
- 9
- Issue
- 12
- Pages
- e112276
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4256304
- OpenAlex
- W2118574085
- Cited by
- 129
- References
- 81
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 9 · 2022: 10 · 2021: 13 · 2020: 16 · 2019: 15 · 2018: 16 · 2017: 18 · 2016: 8 · 2015: 6
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Keywords
- lifestyle intervention, psychosis, weight management, weight loss, weight gain prevention, cardiometabolic risk, depressive symptoms, obesity, waist circumference, triglycerides, fasting blood glucose, insulin, blood pressure, cholesterol
- MeSH terms
- Blood Pressure, Body Weight, Depression, Humans, Insulin Resistance, Life Style, Obesity, Psychotic Disorders, Risk Factors, Weight Loss, Exercise, Body Mass Index
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