Development and initial evaluation of a weight management programme tailored for people with serious mental illness: a non-randomised feasibility study with qualitative interviews

BEST ECR POSTER PRIZE 2022. People with serious mental illness (SMI) have higher rates of obesity and premature mortality due to cardiovascular disease (CVD) than the general population. Trials show behavioural weight management programmes (BWMPs) can help people with SMI lose weight and reduce the burden of CVD. However diagnostic- specific barriers to uptake and engagement are reported. We aimed to develop and evaluate a standard BWMP tailored for people with SMI – called ‘Weight cHange for people with sErious mEntal iLlness (WHEEL).’ The development comprised: 1) 12 patient and public contributors with SMI; 2) a systematic review of qualitative studies to identify programme characteristics that promote uptake and engagement for SMI; 3) a systematic review of trials testing BWMPs to identify which characteristics lead to weight loss; and 4) coding the effective characteristics against a standard 12-week BWMP to identify opportunities for tailored support. Initial evaluation comprised: 5) a non-randomised study of feasibility (retention and n, % of programme sessions attended) and acceptability (qualitative interviews plus self-reported weight loss) at end-of-programme. The programme developed was a weekly BWMP delivered by a commercial company. It was augmented with a one-off educational session geared towards people with SMI and weekly mentor check-ins. Seventeen participants (mean age: 48·52 years; 47% with schizophrenia) enrolled in the feasibility study and 16 were followed-up at 12-weeks (95% retention). All participants attended the educational session, 9/16 attended 50% of the weekly BWMP sessions, and 12/16 responded to 50% of the weekly check-ins. All participants reported weight loss (mean 4·06kg, SD: 3·17) and valued the novel education and therapeutic support. However anxious avoidance remained a barrier to joining the BWMP. This study showed initial evidence that a standard BWMP augmented with brief education and low-intensity support is feasible, acceptable, and may lead to weight loss in people with SMI.