Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Preventing double jeopardy: diabetes and obesity risk minimization in youth with severe mental illness receiving antipsychotic medications. The Keeping the Body in Mind Program. (#47)

Katherine Samaras 1 2 , Jackie Curtis 3 4 , Andrew Watkins 3 , Simone Rosenbaum 3 , Scott Teasdale 3 , Megan Kalucey 3 , Philip Ward 4 5
  1. Department of Endocrinology, St Vincent’s Hospital, Darlinghurst, NSW, Australia
  2. Diabetes and Obesity Clinical Group, Garvan Institute of Medicine, Darlinghurst, NSW, Australia
  3. Early Psychosis Program, Eastern Suburbs Mental Health Program, Bondi, NSW, Australia
  4. School of Psychiatry, University of New South Wales, Kensington, NSW, Australia
  5. Schizophrenia Research Unit, South Western Sydney Local Health District, Liverpool, NSW, Australia


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.

  1. 1) Correll, C. U., Manu, P., Olshanskiy, V., Napolitano, B., Kane, J. M., & Malhotra, A. K. (2009). Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents. JAMA: The Journal of the American Medical Association, 302(16), 1765-1773.