Skip to main content
Article
Effectiveness of a Cognitive Behavioral Weight Management Intervention in Obese Patients with Psychotic Disorders Compared to Patients with Non-Psychotic Disorders or No Psychiatric Disorders: Results from a 12-month, Real-World Study
Journal of Clinical Psychopharmacology
  • Jian-Ping Zhang, MD, PhD
  • Jeffrey J Weiss, PhD
  • Melissa McCardle, Ph.D., Molloy College
  • Hope Klopchin, PhD
  • Eileen Rosendahl, PhD
  • Lawrence Maayan, MD
  • Antonio Convit
  • John M Kane, MD
  • Peter Manu, MD
  • Christoph U Correll, MD
Document Type
Peer-Reviewed Article
Publication Date
8-1-2012
Version
Post-Print
Publisher's Statement
Published in final edited form as: J Clin Psychopharmacol. 2012 August ; 32(4): 458–464. doi:10.1097/JCP.0b013e31825cccd2.
DOI
10.1097/JCP.0b013e31825cccd2
Abstract

Objective—Studies of behavioral weight loss intervention in psychotic patients are sparse and its efficacy compared to other obese patients is unknown. Therefore, we compared the effect of a cognitive-behavioral weight loss intervention in obese subjects with psychotic disorders, other psychiatric diagnoses and without psychiatric disorders. Methods—12-month, naturalistic study of weekly group or individual cognitive-behavioral weight management in 222 consecutively enrolled obese patients (body mass index (BMI): 43.7±9.6) with psychotic-spectrum disorders (PSD, n=47), other psychiatric disorders (OPD, n=49) and no psychiatric disorder (NPD, n=126).

Results—PSD patients had greater treatment persistence (48.9%) and longer treatment duration (8.7±4.4 months) than OPD (22.4%, 5.4±4.3 months) and NPD (22.2%, 4.9±4.7 months) patients (p’s<.01, number-needed-to-treat (NNT)=3). In last-observation-carried-forward analyses, PSD patients had greater percent baseline weight loss at 12 months (5.1±9.3%) than OPD and NPD patients (2.7±5.5% and 2.4±6.3%); greater percent BMI loss at 9 and 12 months than both groups (p’s<.05), and greater BMI loss at 9 months (2.1±3.5) and 12 months (2.3±4.1) than NPD patients (1.1±2.3 and 1.2±2.4). Furthermore, weight loss ≥5%, occurred in 42.6% of PSD patients vs. 18.4% and 23.0% in OPD and NPD patients (p’s<.01, NNT=5 and 6). The strongest weight loss predictor was treatment duration (β=.51–.54, p<.001). Attrition was predicted by NPD (p=.001) and OPD group status (p=.036), lower proportion of group sessions (p=.002), higher depression (p=.028), and lower baseline BMI (p=0.030). Conclusions—Psychosis-spectrum disorder patients had greater weight loss than other obese patients. Non-adherence and depression should be targeted to enhance weight loss success.

Citation Information
Jian-Ping Zhang, Jeffrey J Weiss, Melissa McCardle, Hope Klopchin, et al.. "Effectiveness of a Cognitive Behavioral Weight Management Intervention in Obese Patients with Psychotic Disorders Compared to Patients with Non-Psychotic Disorders or No Psychiatric Disorders: Results from a 12-month, Real-World Study" Journal of Clinical Psychopharmacology Vol. 32 Iss. 4 (2012)
Available at: http://works.bepress.com/melissa-mccardle/3/