In people with mental health problems detained in prison or secure services, or admitted to psychiatric hospital, how effective are any weight loss interventions compared with treatment as usual for the reduction of overweight or obesity?
A few randomised controlled trials have studied weight loss
treatments for psychiatric inpatients in the form of antipsychotic
medication replacement, health promotion, physical activity
programmes and diet control. No clear results have emerged, and
most studies were not of high quality. No research at all has
looked at people with mental health problems detained in
Clinical and research implications
No definite clinical implications may be made based on the
available evidence. The authors of a systematic review suggested
that switching to an antipsychotic medication which is less likely
to cause weight gain and metabolic problems may be beneficial, but
that better designed trials with adequate power would provide more
convincing evidence to use this approach as an intervention
strategy. Trials evaluating health promotion, dietary control and
physical activity interventions yielded mixed results, and
similarly, higher quality trials are required to more conclusively
evaluate such interventions. Of note, no relevant high quality
research has been conducted in prison, nor high secure mental
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