Effects of a behavioural weight loss intervention in people with serious mental illness: Subgroup analyses from the ACHIEVE trial

Obes Res Clin Pract. 2019 Mar-Apr;13(2):205-210. doi: 10.1016/j.orcp.2019.02.002. Epub 2019 Mar 7.


Background: Persons with serious mental illnesses (SMI) such as schizophrenia and bipolar disorder have an increased risk of obesity and related chronic diseases and die 10-20years earlier than the overall population, primarily due to cardiovascular disease. In the ACHIEVE trial, a behavioural weight loss intervention led to clinically significant weight loss in persons with SMI. As the field turns its attention to intervention scale-up, it is important to understand whether the effectiveness of behavioural weight loss interventions for people with SMI, like ACHIEVE, differ for specific subgroups.

Methods: This study examined whether the effectiveness of the ACHIEVE intervention differed by participant characteristics (e.g. age, sex, race, psychiatric diagnosis, body mass index) and/or their weight-related attitudes and behaviours (e.g. eating, food preparation, and shopping habits). We used likelihood-based mixed effects models to examine whether the baseline to 18 month effects of the ACHIEVE intervention differed across subgroups.

Results: No statistically significant differences were found in the effectiveness of the ACHIEVE intervention across any of the subgroups examined.

Conclusions: These findings suggest that the ACHIEVE behavioural weight loss intervention is broadly applicable to the diverse population of individuals with SMI.

Keywords: Behavioural weight loss intervention; Obesity; Serious mental illness (SMI).

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Behavior Therapy*
  • Body Mass Index
  • Comorbidity
  • Female
  • Health Surveys
  • Humans
  • Male
  • Maryland / epidemiology
  • Mental Disorders / complications
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Obesity / epidemiology
  • Obesity / prevention & control*
  • Obesity / psychology
  • Patient Compliance
  • Psychotherapy, Group
  • Treatment Outcome
  • Weight Loss / physiology*
  • Young Adult