Effects of Behavioral Therapy on Weight Loss in Overweight and Obese Patients With Schizophrenia or Schizoaffective Disorder

Background: Obesity is common in persons with schizophrenia. Besides its adverse health effects, obesity reduces quality of life and contributes to the social stigma of schizophrenia.

Method: This 14-week, multicenter, open-label, rater-blinded, randomized study evaluated the effects of a group-based behavioral treatment (BT) for weight loss in overweight and obese stable patients with DSM-IV schizophrenia or schizoaffective disorder who had been switched from olanzapine to risperidone. Participants were randomly assigned to receive BT or usual clinical care (UC). BT included 20 sessions during which patients were taught to reduce caloric intake. In UC, patients were encouraged to lose weight but received no special advice about weight reduction. The primary outcome measure was change in body weight.

Results: Seventy-two patients were enrolled. The mean ± SD weight loss at endpoint was significant in both groups (p < .05) and numerically greater in patients receiving BT than in those receiving UC (-2.0 ± 3.79 and -1.1 ± 3.11 kg, respectively). More patients in the BT group than in the UC group had lost ≥ 5% of their body weight at endpoint (26.5% [9/34] and 10.8% [4/37], respectively; p = .082). A post hoc analysis of patients attending at least 1 BT session showed that significantly more patients in the BT than the UC group had lost ≥ 5% of their body weight at endpoint (32.1% [9/28] vs. 10.8% [4/37], respectively, p = .038) and at week 14 (completer population; 40.9% [9/22] and 14.3% [4/28], respectively, p = .027).

Conclusion: BT may be an effective method for weight reduction in patients with chronic psychotic illness. ‘ ‹