Mental Illness Research, Education and Clinical Center, Veterans Affairs Capitol Health Care Network (Veterans Integrated Service Network 5), 10 North Greene St., Baltimore, MD 21201, USA.
Psychiatr Serv. 2013 Aug 1;64(8):737-44. doi: 10.1176/appi.ps.201200314.
Veterans with serious mental illness are at increased risk of obesity, sedentary lifestyle, and a host of related chronic diseases. Although evidence suggests that lifestyle interventions can help mental health consumers achieve modest weight loss, several studies have failed to show a benefit and most have concluded that significant challenges remain in delivering effective interventions. In 2006, the Veterans Health Administration introduced MOVE!, a weight management program that includes behaviorally based dietary and physical activity self-management support. This article describes modifications used to manualize MOVE! for veterans with serious mental illness and reports findings from a randomized controlled trial of the new intervention.
Between January 2007 and June 2009, overweight or obese veterans with serious mental illness were randomly assigned to a six-month trial of MOVE! (N=53), which includes both individual and group sessions, or to a control condition that offered basic information about diet and exercise every month (N=56). Weight and metabolic, attitudinal, behavioral, and functional variables were measured at baseline and six months, and weight was also measured monthly.
Thirty participants in MOVE! and 41 participants in the control group completed the six-month assessment, and only seven lost 5% of their baseline weight; there was no effect of group assignment on weight loss. There were no significant group × time differences in any metabolic, dietary, physical activity, attitudinal, or functional measure.
Despite the negative findings of this study, research is crucial to identify lifestyle interventions and related supports and services to help veterans with mental illness reduce overweight and obesity.
患有严重精神疾病的退伍军人肥胖、生活方式久坐不动以及一系列相关慢性疾病的风险增加。尽管有证据表明生活方式干预可以帮助精神健康消费者实现适度的体重减轻，但几项研究未能显示出益处，而且大多数研究得出的结论是，在提供有效的干预措施方面仍存在重大挑战。2006 年，退伍军人事务部推出了 MOVE！，这是一个体重管理计划，包括基于行为的饮食和身体活动自我管理支持。本文描述了为患有严重精神疾病的退伍军人手动 MOVE！的修改，并报告了新干预措施的随机对照试验结果。
2007 年 1 月至 2009 年 6 月期间，超重或肥胖的患有严重精神疾病的退伍军人被随机分配到 MOVE！（N=53）的为期六个月的试验中，其中包括个人和小组会议，或分配到控制组，每月提供有关饮食和运动的基本信息（N=56）。在基线和六个月时测量体重和代谢、态度、行为和功能变量，并且每月测量体重。
30 名 MOVE！参与者和 41 名对照组参与者完成了六个月的评估，只有 7 人减轻了 5%的基线体重；组分配对体重减轻没有影响。在任何代谢、饮食、身体活动、态度或功能指标方面，均未观察到组间×时间差异。
尽管这项研究的结果为阴性，但研究对于确定生活方式干预措施以及相关的支持和服务以帮助患有精神疾病的退伍军人减轻超重和肥胖至关重要。
