0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Articles   |    
“MOVE!”: Outcomes of a Weight Loss Program Modified for Veterans With Serious Mental Illness
Richard W. Goldberg, Ph.D.; Gloria Reeves, M.D.; Stephanie Tapscott, M.S.; Deborah Medoff, Ph.D.; Faith Dickerson, Ph.D.,M.P.H.; Andrew P. Goldberg, M.D.; Alice S. Ryan, Ph.D.; Li Juan Fang, M.S.; Lisa B. Dixon, M.D., M.P.H.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200314
View Author and Article Information

Dr. Richard W. Goldberg is affiliated with the Mental Illness Research, Education and Clinical Center and Dr. Andrew P. Goldberg and Dr. Ryan are with the Geriatric Research, Education and Clinical Center, Veterans Affairs Capitol Health Care Network (Veterans Integrated Service Network 5), 10 North Greene St., Baltimore, MD 21201 (e-mail: Richard.Goldberg@va.gov). Dr. Richard W. Goldberg is also with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore, where Dr. Reeves, Ms. Tapscott, Dr. Medoff, and Ms. Fang are also affiliated. Dr. Dickerson is with the Sheppard Pratt Health System, Baltimore. Dr. Dixon is with the Department of Psychiatry, Columbia University, and with the New York State Psychiatric Institute, New York City.

Copyright © 2013 by the American Psychiatric Association

Abstract

Objectives  Veterans with serious mental illness are at increased risk of obesity, sedentary lifestyle, and a host of related chronic diseases. Although evidence suggests that lifestyle interventions can help mental health consumers achieve modest weight loss, several studies have failed to show a benefit and most have concluded that significant challenges remain in delivering effective interventions. In 2006, the Veterans Health Administration introduced MOVE!, a weight management program that includes behaviorally based dietary and physical activity self-management support. This article describes modifications used to manualize MOVE! for veterans with serious mental illness and reports findings from a randomized controlled trial of the new intervention.

Methods  Between January 2007 and June 2009, overweight or obese veterans with serious mental illness were randomly assigned to a six-month trial of MOVE! (N=53), which includes both individual and group sessions, or to a control condition that offered basic information about diet and exercise every month (N=56). Weight and metabolic, attitudinal, behavioral, and functional variables were measured at baseline and six months, and weight was also measured monthly.

Results  Thirty participants in MOVE! and 41 participants in the control group completed the six-month assessment, and only seven lost 5% of their baseline weight; there was no effect of group assignment on weight loss. There were no significant group × time differences in any metabolic, dietary, physical activity, attitudinal, or functional measure.

Conclusions  Despite the negative findings of this study, research is crucial to identify lifestyle interventions and related supports and services to help veterans with mental illness reduce overweight and obesity.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Anchor for Jump
Table 1Summary of the MOVE! weight loss intervention optimized for use with veterans with serious mental illness
Anchor for Jump
Table 2Characteristics of veterans in the MOVE! weight loss intervention and a control condition, at baselinea
Table Footer Note

a The control condition was treatment as usual plus monthly weigh-ins and distribution of diet- and exercise-related brochures and handouts.

Table Footer Note

b Fisher’s exact test

Anchor for Jump
Table 3Group × time interaction at six-month follow-up among veterans in the MOVE! weight loss intervention and a control group, by outcomea
Table Footer Note

a The control condition was treatment as usual plus monthly weigh-ins and distribution of diet- and exercise-related brochures and handouts. Percentages reflect the number of respondents for whom data were available for each outcome.

Table Footer Note

b F test (SAS Proc mixed); Wald χ2 (SAS Proc Genmod with binomial distribution specified)

Table Footer Note

c ≥3 of the following: hypertension, increased waist circumference, dyslipidemia, and hyperglycemia

Table Footer Note

d Wald χ2 (SAS Proc Genmod with Poisson distribution specified)

Table Footer Note

e Results are for the Block Fruit, Vegetable, and Dietary Fat Screeners.

Table Footer Note

f Diet and Exercise Confidence Survey. Possible scores range from 20 to 100, with higher scores indicating higher confidence in controlling diet.

Table Footer Note

g Possible scores range from 12 to 60, with higher scores indicating higher confidence in exercise.

Table Footer Note

h Possible scores range from 0 to 10, with higher scores indicating greater perceived importance.

Table Footer Note

i Possible scores range from 0 to 10, with higher scores indicating higher confidence.

Table Footer Note

j Impact of Weight on Quality of Life. Possible scores range from 0 to 100, with higher scores indicating lower impact of weight on quality of life.

Table Footer Note

k 12-Item Short Form composites are norm-based scores (mean±SD=50±10). Scores above 50 can be interpreted as above the general population norm.

+

References

Confronting the obesity epidemic. Chronic Disease: Notes and Reports 19:29–32, 2009. Available at www.cdc.gov/chronicdisease/resources/publications/cdnr/pdf/cdnr-feb-2009.pdf
 
Allison  DB;  Newcomer  JW;  Dunn  AL  et al:  Obesity among those with mental disorders: a National Institute of Mental Health meeting report.  American Journal of Preventive Medicine 36:341–350, 2009
[CrossRef] | [PubMed]
 
Parks J, Svensen D, Singer P, et al (eds): Morbidity and Mortality in People With Serious Mental Illness. Alexandria, Va, National Association of State Mental Health Program Directors, 2006
 
Compton  MT;  Daumit  GL;  Druss  BG:  Cigarette smoking and overweight/obesity among individuals with serious mental illnesses: a preventive perspective.  Harvard Review of Psychiatry 14:212–222, 2006
[CrossRef] | [PubMed]
 
American Diabetes Association; American Psychiatric Association; American Association of Clinical Endocrinologists, et al:  Consensus development conference on antipsychotic drugs and obesity and diabetes.  Journal of Clinical Psychiatry 65:267–272, 2004
[CrossRef] | [PubMed]
 
Allison  DB;  Mentore  JL;  Heo  M  et al:  Antipsychotic-induced weight gain: a comprehensive research synthesis.  American Journal of Psychiatry 156:1686–1696, 1999
[PubMed]
 
Cabassa  LJ;  Ezell  JM;  Lewis-Fernández  R:  Lifestyle interventions for adults with serious mental illness: a systematic literature review.  Psychiatric Services 61:774–782, 2010
[CrossRef] | [PubMed]
 
Gabriele  JM;  Dubbert  PM;  Reeves  RR:  Efficacy of behavioural interventions in managing atypical antipsychotic weight gain.  Obesity Reviews 10:442–455, 2009
[CrossRef] | [PubMed]
 
Weber  M;  Wyne  K:  A cognitive/behavioral group intervention for weight loss in patients treated with atypical antipsychotics.  Schizophrenia Research 83:95–101, 2006
[CrossRef] | [PubMed]
 
Skrinar  GS;  Huxley  NA;  Hutchinson  DS  et al:  The role of a fitness intervention on people with serious psychiatric disabilities.  Psychiatric Rehabilitation Journal 29:122–127, 2005
[CrossRef] | [PubMed]
 
Rotatori  AF;  Fox  R;  Wicks  A:  Weight loss with psychiatric residents in a behavioral self-control program.  Psychological Reports 46:483–486, 1980
[CrossRef] | [PubMed]
 
Jean-Baptiste  M;  Tek  C;  Liskov  E  et al:  A pilot study of a weight management program with food provision in schizophrenia.  Schizophrenia Research 96:198–205, 2007
[CrossRef] | [PubMed]
 
Littrell  KH;  Hilligoss  NM;  Kirshner  CD  et al:  The effects of an educational intervention on antipsychotic-induced weight gain.  Journal of Nursing Scholarship 35:237–241, 2003
[CrossRef] | [PubMed]
 
McKibbin  CL;  Patterson  TL;  Norman  G  et al:  A lifestyle intervention for older schizophrenia patients with diabetes mellitus: a randomized controlled trial.  Schizophrenia Research 86:36–44, 2006
[CrossRef] | [PubMed]
 
Douketis  JD;  Macie  C;  Thabane  L  et al:  Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice.  International Journal of Obesity 29:1153–1167, 2005
[CrossRef] | [PubMed]
 
Franz  MJ;  VanWormer  JJ;  Crain  AL  et al:  Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up.  Journal of the American Dietetic Association 107:1755–1767, 2007
[CrossRef] | [PubMed]
 
Brown  AH;  Cohen  AN;  Chinman  MJ  et al:  EQUIP: implementing chronic care principles and applying formative evaluation methods to improve care for schizophrenia: QUERI series.  Implementation Science 3:1–12, 2008
[CrossRef] | [PubMed]
 
Ryan  S;  Littrell  K;  Sowers  C  et al:  Solutions for Wellness .  Indianapolis, Ind,  Eli Lilly, 2000
 
Niv  N;  Cohen  AN;  Hamilton  A  et al:  Effectiveness of a psychosocial weight management program for individuals with schizophrenia.  Journal of Behavioral Health Services and Research  (Epub ahead of print, March 20, 2012)
 
Kahwati  LC;  Lewis  MA;  Kane  H  et al:  Best practices in the Veterans Health Administration’s MOVE! weight management program.  American Journal of Preventive Medicine 41:457–464, 2011
[CrossRef] | [PubMed]
 
Kahwati  LC;  Lance  TX;  Jones  KR  et al:  RE-AIM evaluation of the Veterans Health Administration’s MOVE! weight management program.  Translational Behavioral Medicine 1:551–560, 2011
[CrossRef]
 
Thomas  S;  Reading  J;  Shephard  RJ:  Revision of the Physical Activity Readiness Questionnaire (PAR-Q).  Canadian Journal of Sport Sciences 17:338–345, 1992
[PubMed]
 
Dixon  LB;  Dickerson  F;  Bellack  AS  et al:  The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements.  Schizophrenia Bulletin 36:48–70, 2010
[CrossRef] | [PubMed]
 
Move!23 Questionnaire. Washington, DC, US Department of Veterans Affairs, National Center for Health Promotion and Disease Prevention, 2013. Available at www.move.va.gov/move23.asp
 
Block Fruit, Vegetable, and Fiber Screener. Berkeley, Calif, Nutrition Quest, 2013. Available at www.nutritionquest.com/assessment
 
Block Dietary Fat Screener. Berkeley, Calif, Nutrition Quest, 2013. Available at www.nutritionquest.com/assessment
 
Sallis  JF;  Pinski  RB;  Grossman  RM, et al:  The development of self-efficacy scales for health-related diet and exercise behaviors.  Health Education Research 3:283–292, 1998
[CrossRef]
 
Kolotkin  RL;  Crosby  RD;  Kosloski  KD  et al:  Development of a brief measure to assess quality of life in obesity.  Obesity Research 9:102–111, 2001
[CrossRef] | [PubMed]
 
Ware  JE  Jr;  Kosinski  M;  Keller  SD:  A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.  Medical Care 34:220–233, 1996
[CrossRef] | [PubMed]
 
Daumit  GL;  Dalcin  AT;  Jerome  GJ  et al:  A behavioral weight-loss intervention for persons with serious mental illness in psychiatric rehabilitation centers.  International Journal of Obesity 35:1114–1123, 2011
[CrossRef] | [PubMed]
 
VA Patient Aligned Care Team. Washington, DC, US Department of Veterans Affairs, Nov 17, 2010. Available at www.va.gov/primarycare/pcmh/
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Web of Science® Times Cited: 1

Related Content
Books
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 28.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 25.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 50.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 48.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 28.  >
Topic Collections
Psychiatric News
PubMed Articles