Prevalence of Overweight and Obesity in People With Severe Mental Illness: Systematic Review and Meta-Analysis

Author:

Afzal Medhia,Siddiqi Najma,Ahmad Bilal,Afsheen Nida,Aslam Faiza,Ali Ayaz,Ayesha Rubab,Bryant Maria,Holt Richard,Khalid Humaira,Ishaq Kousar,Koly Kamrun Nahar,Rajan Sukanya,Saba Jobaida,Tirbhowan Nilesh,Zavala Gerardo A.

Abstract

Aims1) To determine the pooled prevalence of overweight and obesity in people with severe mental illness (SMI), overall and by type of SMI, geographical region, and year of data collection; and 2) to assess the likelihood of overweight and obesity, in people with SMI compared with the general population.MethodsPubMed, Medline, EMBASE, and PsycINFO databases were searched to identify observational studies assessing the prevalence of obesity in adults with SMI. Screening, data extraction and risk of bias assessments were performed independently by two co-authors. Random effect estimates for the pooled prevalence of overweight and obesity and the pooled odds of obesity in people with SMI compared with the general population were calculated. Subgroup analyses were conducted for types of SMI, setting, antipsychotic medication, region of the world, country income classification, date of data collection and sex. We assessed publication bias and performed a series of sensitivity analyses, excluding studies with high risk of bias, with low sample size and those not reporting obesity according to WHO classification.Result120 studies from 43 countries were included, the majority were from high income countries. The pooled prevalence of obesity in people with SMI was 25.9% (95% C.I. = 23.3-29.1) and the combined pooled prevalence of overweight and obesity was 60.1% (95% C.I. = 55.8-63.1). Sub-Saharan Africa (13.0%, 95%C.I. = 6.7-25.1) and South Asia (17.7%, 95%C.I. = 10.5-28.5) had the lowest prevalence of obesity whilst North Africa and the Middle East (35.8%, 95%C.I. = 23.8-44.8) reported the highest prevalence. People with SMI were 3.04 more likely (95% C.I. = 2.42-3.82) to have obesity than the general population, but there was no difference in the prevalence of overweight. Women with schizophrenia were 1.44 (95% C.I. = 1.25-1.67) times more likely than men with schizophrenia to live with obesity; however, no gender differences were found among those with bipolar disorder.ConclusionPeople with SMI have a markedly high prevalence and higher odds of obesity than the general population. This may contribute to the very high prevalence of physical health conditions and mortality in this group. People with SMI around the world would likely benefit from interventions to reduce and prevent obesity.

Funder

National Institute for Health Research

Publisher

Frontiers Media SA

Subject

Endocrinology, Diabetes and Metabolism

Reference56 articles.

1. Others. Obesity and Overweight.2020

2. The High Prevalence of Poor Physical Health and Unhealthy Lifestyle Behaviours in Individuals With Severe Mental Illness;Scott;Issues Ment Health Nurs,2011

3. Preventive Medical Care in Psychiatry: A Practical Guide for Clinicians;McCarron;Am Psychiatr Pub,2015

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