Non‐pharmacologicaL InterVEntions for Antipsychotic‐Induced Weight Gain (RESOLVE) in people living with severe mental illness: A realist synthesis

MacPhee, Maura, Howe, Jo, Habib, Hafsah, Piwowarczyk, Emilia, Wong, Geoff, Ahern, Amy, Birdi, Gurkiran, Higgs, Suzanne, Oduola, Sheri, Kenny, Alex, Walsh, Annabel, Upthegrove, Rachel, Allen, Katherine, Carlish, Max, Lovell, Justine and Maidment, Ian (2025) Non‐pharmacologicaL InterVEntions for Antipsychotic‐Induced Weight Gain (RESOLVE) in people living with severe mental illness: A realist synthesis. Obesity Reviews. ISSN 1467-7881

[thumbnail of Non‐pharmacologicaL InterVEntions for Antipsychotic‐Induced Weight Gain RESOLVE in]
Preview
PDF (Non‐pharmacologicaL InterVEntions for Antipsychotic‐Induced Weight Gain RESOLVE in) - Published Version
Available under License Creative Commons Attribution.

Download (649kB) | Preview

Abstract

Introduction: Antipsychotic medications are used to treat individuals with severe mental illness (SMI) but are associated with rapid weight gain and several physical and mental risk factors. Early, proactive weight management is necessary to preempt these risk factors. The aim of this research was to understand and explain how, why, for whom, and in what contexts non-pharmacological interventions can help to manage antipsychotic-induced weight gain. Methods: A realist review was conducted to identify contextual factors and underlying mechanisms associated with effective, non-pharmacological weight management interventions for adults > 18-years old. Practitioners and lived experience stakeholders were integral. Results: Seventy-four documents were used to construct a program theory and 12 testable context-mechanism-outcome configurations. People with SMI benefit from support when navigating interventions aimed at managing weight gain. From a practitioner perspective, a good therapeutic relationship is important in helping people with SMI navigate early diagnosis and treatment options and facilitate the exploriation of any pre-existing issues. Interventions that are flexible and tailored to the needs of individuals, ideally starting early in a person's recovery journey, are likely to yield better results. Additional sources of support include family, friends, and peers with lived experience who can help individuals transition to autonomous goal-setting. The review findings also emphasizes the significant effect of stigma/dual stigma on individuals with SMI and weight gain. Conclusions: Successful interventions are collaborative, flexible, and underpinned by early and comprehensive assessment with the use of appropriate behavior change approaches. The therapeutic relationship is key, with a destigmatizing approach required. A realist evaluation with primary data is currently underway.

Item Type: Article
Additional Information: This publication presents independent research commissioned by the National Institute for Health and Care Research (NIHR: HSDR grant number—131871). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NIHR or the Department of Health and Social Care. R.U. is supported by the NIHR Oxford Health Biomedical Research Centre. A.A. is funded by the Medical Research Council (grant MC_UU_00006/6) and the NIHR Cambridge Biomedical Research Centre. We thank Claire Duddy for conducting the searches for this review.
Uncontrolled Keywords: antipsychotics,cardiometabolic syndrome,lived experience,obesity,realist research,realist review,severe mental illness,weight gain,public health, environmental and occupational health,endocrinology, diabetes and metabolism,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2739
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Health Promotion
Faculty of Medicine and Health Sciences > Research Centres > Public Health
Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health)
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 29 Jul 2025 15:30
Last Modified: 16 Aug 2025 00:40
URI: https://ueaeprints.uea.ac.uk/id/eprint/99992
DOI: 10.1111/obr.13962

Downloads

Downloads per month over past year

Actions (login required)

View Item View Item