People with severe mental illness have greater risk of diabetes and a 20-y mortality gap due to premature cardiovascular disease. Diabetes risk starts early, accentuated by co-existing obesity. Antipsychotic medication (APM) initiation induces rapid deterioration in metabolic health within 12 weeks, with 80% experiencing clinically significant (>7%) weight-gain1.
To determine whether a 12-week multi-disciplinary early intervention in youth with first episode psychosis (FEP) attenuated weight gain and decline in metabolic health.
Youth with FEP (15-25y) participated in a 12-week multidisciplinary intervention, the Keeping the Body in Mind Program (KBIM). The program included weekly (i) individualized diet education and support with a dietitian, (ii) individualised exercise programming with an exercise physiologist with access to an on-site gym and (iii) life skills group education, including shopping, budgeting and cooking classes. Controls were youth with FEP in another Sydney service. Outcomes: weight, waist; fasting lipids and glucose, exercise capacity (VO2 max) and energy intake.
16 participants (mean±SD age 20.0±2.3y) undertook the intervention. Controls (n=11, aged 21.7±2.0y) were similar in age and APM prescribed.
At 12w, KBIM was associated with substantially less gain in weight (1.2±0.7 vs. 7.3 k±1.3kg, p < 0.001) and waist (0.1 vs. 6.3 cm, p < 0.001).
The KBIM program abrogated the expected deterioration in metabolic parameters (glucose, lipids, blood pressures) and significantly improved VO2 max (p=0.01) and energy intake (p < 0.001).
Early multidisciplinary lifestyle intervention can abrogate the negative metabolic outcomes associated with anti-psychotic medication in this vulnerable population of young people. Early lifestyle intervention for diabetes prevention may reduce the disparity in life expectancy in people with severe mental illness.