Obesity and Physical Inactivity

Obesity and physical inactivity have reached epidemic proportions in the United States resulting in increased rates of a variety of chronic diseases, increased risk of mortality, and substantial health care costs. Adults with schizophrenia and other serious mental illnesses (SMI) are more likely to be overweight or obese, which likely contributes to the higher rates of co-morbid medical disease and early mortality found among this population.

Being overweight or obese has also been shown to reduce general health functioning, quality of life, and adherence to medication. Therefore, successful behavioral treatment of obesity among those with SMI will have multiple and far reaching physical and psychiatric health benefits.

MOVE!

The VA National Center for Health Promotion and Disease Prevention (NCP) recently developed a weight management and physical activity program entitled MOVE! (Managing, Overweight/Obesity for Veterans Everywhere) for the general veteran population. MOVE! uses existing evidence-based techniques and materials and can be adapted as necessary for seamless transition into a variety of ambulatory care settings within the VA.

Despite its potential, it has proven to be quite difficult to disseminate because patients with SMI often have limited transportation options and may not want to participate in groups. Furthermore, in-person MOVE! requires a substantial time commitment from mental health clinicians, blocking implementation at many VA centers. However, it is very likely that these barriers can be addressed with a computerized, web-based version of MOVE! that is tailored specifically for veterans with SMI.

Specialized web-based approaches have been studied and found to be successful in this population. A web-based system can deliver content that is intensive and engaging with minimal requirements for staff time.

NeuroComp is currently developing a web-based version titled "MOVE.Net" that is specifically adapted to meet the needs of veterans with SMI. In Phase I NeuroComp is developing a comprehensive web-based system that delivers MOVE! using design features that enable self-administration of the MOVE! program content via a web connection.

By losing weight, veterans with SMI can decrease their risk for certain medical problems that have a serious negative effect on their quality of life and life expectancy. A web-based system that helps veterans lose weight could be disseminated broadly at VA sites, including medical centers and community based outpatient clinics serving both rural and urban areas.