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Meta-Analysis
. 2014 Dec 4;9(12):e112276.
doi: 10.1371/journal.pone.0112276. eCollection 2014.

The effects of lifestyle interventions on (long-term) weight management, cardiometabolic risk and depressive symptoms in people with psychotic disorders: a meta-analysis

Jojanneke Bruins  1 , Frederike Jörg  2 , Richard Bruggeman  1 , Cees Slooff  3 , Eva Corpeleijn  4 , Marieke Pijnenborg  5
Affiliations
Meta-Analysis

The effects of lifestyle interventions on (long-term) weight management, cardiometabolic risk and depressive symptoms in people with psychotic disorders: a meta-analysis

Jojanneke Bruins et al. PLoS One. .

Abstract

Aims: The aim of this study was to estimate the effects of lifestyle interventions on bodyweight and other cardiometabolic risk factors in people with psychotic disorders. Additionally, the long-term effects on body weight and the effects on depressive symptoms were examined.

Material and methods: We searched four databases for randomized controlled trials (RCTs) that compared lifestyle interventions to control conditions in patients with psychotic disorders. Lifestyle interventions were aimed at weight loss or weight gain prevention, and the study outcomes included bodyweight or metabolic parameters.

Results: The search resulted in 25 RCTs -only 4 were considered high quality- showing an overall effect of lifestyle interventions on bodyweight (effect size (ES) = -0.63, p<0.0001). Lifestyle interventions were effective in both weight loss (ES = -0.52, p<0.0001) and weight-gain-prevention (ES = -0.84, p = 0.0002). There were significant long-term effects, two to six months post-intervention, for both weight-gain-prevention interventions (ES = -0.85, p = 0.0002) and weight loss studies (ES = -0.46, p = 0.02). Up to ten studies reported on cardiometabolic risk factors and showed that lifestyle interventions led to significant improvements in waist circumference, triglycerides, fasting glucose and insulin. No significant effects were found for blood pressure and cholesterol levels. Four studies reported on depressive symptoms and showed a significant effect (ES = -0.95, p = 0.05).

Conclusion: Lifestyle interventions are effective in treating and preventing obesity, and in reducing cardiometabolic risk factors. However, the quality of the studies leaves much to be desired.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist. Jojanneke Bruins has received financial support from Eli Lilly to carry out the meta-analysis and prepare the manuscript. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Prisma 2009 Flow Diagram.
Figure 2
Figure 2. Forest plot a) describes the effects of lifestyle interventions on bodyweight.
Forest plot b) describes the longterm effects of lifestyle interventions on body weight. Forest plot c) describes the effects of lifestyle interventions on depressive symptoms.
See this image and copyright information in PMC

References

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