Behavioral weight loss classes for patients with severe mental illness.

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There is much skepticism and stigma about whether patients withsevere mental illness can participate in, understand, and benefitfrom a behavioral approach to weight loss. Many fitness programs,even those provided by medical facilities to their outpatientpopulation, exclude patients with severe mental illness. Thisleaves this population without a source of information or supportfor weight loss, and obesity is a problem often caused by suchpsychiatric medications as second-generation antipsychotics.The purpose of our study was to adapt the behavioral weightloss program that was used in the Diabetes Prevention Programfor use in a population with mental illness. Our three pilotstudies found that patients with severe mental illness not onlyhave the capacity to learn from such programs but also havethe commitment to benefit from them.

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Our patients responded well to consistent positive reinforcementfor every step forward. We tempered our expectations to eachpatient’s individual needs and applauded any and all positivechange. With this approach, we slowly saw changes in the patients’attitudes, behaviors, and ability to maintain weight loss. Amore formal assessment of our behavioral weight loss programis ongoing.