Nonetheless, patients with serious mental illness face unique barriers to engaging in weight management programs. In the study by Goldberg and colleagues, many participants depended on others for shopping and cooking, and most had at least one co-occurring general medical condition, notably arthritis and joint pain (51%) or diabetes (30%). Outside VHA, persons with serious mental illness face the additional challenge of accessing medical services, especially because the mental health system is their de facto source of care. Recent interventions—such as Project Achieve (4), which that resulted in significant weight loss (>5%) for persons with serious mental illness—have integrated healthy food options and physical activity for patients at outpatient mental health facilities (1). Emerging community-based initiatives, notably in Genesee County, Michigan (5), have addressed system- and community-level barriers to weight management, primarily through colocation of general medical and mental health providers and implementation of programs that involve community reintegration opportunities through local gyms and nutrition classes. One of the Genesee County weight management programs (InShape) was associated with >5% weight loss in a predominantly African-American population engaged in the program for at least a year.