Abstract
BackgroundPeople with severe mental illness are two to three times more likely to be overweight or have obesity than the general population and this is associated with significant morbidity and premature mortality. Liraglutide 3 mg is a once daily injectable GLP-1 receptor agonist that is licensed for the treatment of obesity in the general population and has the potential to be used in people with severe mental illness.AimsTo record the expectations and experiences of people with schizophrenia, schizoaffective disorders or first episode psychosis taking daily liraglutide 3 mg injections in a clinical trial for the treatment of obesity.To seek the views of healthcare professionals about the feasibility of delivering the intervention in routine care.MethodsQualitative interviews were undertaken with a purposive sub-sample of people with schizophrenia, schizoaffective disorders or first episode psychosis with overweight or obesity who were treated with a daily injection of liraglutide 3 mg in a double-blinded, randomised controlled pilot study evaluating the use of liraglutide for the treatment of obesity. Interviews were also conducted with healthcare professionals.ResultsSeventeen patient participants were interviewed. Sixteen took part in the baseline interview, eight completed both baseline and follow-up interviews, and one took part in follow-up interview only. Mean interview duration was thirteen minutes (range 5-37 min). Despite reservations by some participants about the injections before the study, most of those who completed the trial reported no challenges in the timing of or administering the injections. Key themes included despondency regarding prior medication associated weight gain, quality of life impact of weight loss, practical aspects of participation including materials received and clinic attendance. Healthcare professionals reported challenges with recruitment, however, overall it was a positive experience for them and for participants.ConclusionLiraglutide appears to be an acceptable therapy for obesity in this population with limited side effects. The quality of life benefits realised by several intervention participants reinforce the biomedical benefits of achieved weight loss.
Highlights
People with severe mental illness are two to three times more likely to be overweight or have obesity than the general population and this is associated with significant morbidity and premature mortality
Qualitative interviews were undertaken with a purposive sub-sample of people with schizophrenia, schiz‐ oaffective disorders or first episode psychosis with overweight or obesity who were treated with a daily injection of liraglutide 3 mg in a double-blinded, randomised controlled pilot study evaluating the use of liraglutide for the treat‐ ment of obesity
Liraglutide appears to be an acceptable therapy for obesity in this population with limited side effects
Summary
People with severe mental illness are two to three times more likely to be overweight or have obesity than the general population and this is associated with significant morbidity and premature mortality. The rates of overweight and obesity are 2-3-fold higher in people with severe mental illness than in the general population [1]. Obesity adversely affects the physical health and psychological well-being of people with severe mental illness and contributes to the 2-3 fold excess morbidity and mortality experienced by this population. Several pharmacological treatments have been subject to clinical studies, but currently the only drug therapy licensed for the treatment of antipsychotic-associated weight gain, or for obesity in people with severe mental illness is orlistat [3]. The long-term use of this drug, is extremely limited due to high discontinuation rates, it is of limited value in routine clinical practice [4]
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