P.3.f.010 Outcomes of a diet and fitness program for patients with schizophrenia

Abstract

Background:Weight gain and metabolic syndrome caused by new generation antipsychotics is a major health problem in patients with schizophrenia. Obesity and its related morbidity has been shown to be one of the major causes for schizophrenia patients’ reduced life expectancy [1]. Exercise therapy can improve mental and physical health in schizophrenia patients [2]. The primary objective of this study was to test whether a supervised diet and fitness program would lead to weight loss in schizophrenia patients. The secondary goal was to check for correlation between weight loss under the program and the type and dose of antipsychotic medication received. Methods: Over a period of one year twelve medical representatives of the Eli Lilly Company met with ambulatory psychiatrists all over Israel. The aim was to locate stabilized patients with schizophrenia who were willing to participate in a diet and fitness program that was sponsored by the company during that year. Standard physical examination, routine blood tests and EEG were required. Patients that qualified were referred to a special fitness center in their residential neighborhood and participated in groups of ten. Upon arrival to the fitness center the group of patients met with a professional fitness instructor that was specially trained regarding the patients’ sensitivity and difficulties. Patients were encouraged to exercise at least 3 times a week. Additionally, a custom-made diet was adjusted to each patient with the skills of clinical dietician taking into account their personal preferences and economical limitations. Weight and circumferences of abdomen, pelvis and thigh were measured at baseline and every month. Results: Ninety eight patients with schizophrenia started the program, 55 of which attended for at least a month (36 males). The age of the persistent patients was 28±4.6 years, the time of attendance was 3±2.2 months. Overall the accumulated weight loss of the whole group was significant (86.63±15.12 kg baseline; 83.091±14.12 kg end of program; F=20.87, p< 0.0001). A positive correlation was found between the months of participation in the program and the weight loss (r = 0.521, p = 0.0003). We found no association between a specific type of medications and the amount of weight lost (F = 0.437, p = 0.85). No correlation was found between chlorpromazine equivalent dose of medications and weight loss (r = −0.101, p = 0.5). Discussion: Schizophrenia patients who participated in our diet and fitness program succeeded in losing weight. The adherence to our program was 56%, this rate is similar to that of healthy people participating in a diet and fitness program [3]. As expected longer participation in the program was associated with more weight lost. We found no difference in the weight reduction of patients taking different types of medications, including quetiapine, olanzapine and clozapine that are known to cause weight gain and metabolic syndrome. Conclusions: Patients with schizophrenia can participate in a diet and fitness programs and succeed in reducing weight similarly to the normal population. There was no correlation between the type of medication and weight lost.