Randomized Trial Of Achieving Healthy Lifestyles In Psych Rehabilitation (ACHIEVE)

Age 18 and older;

• Overweight, defined by Body Mass Index at least 25.0 kg/m2;
• Able and willing to give informed consent and participate in the intervention;
• On the same psychiatric medications within the 30 days before baseline weight (dose changes allowed;)
• Able to attend at least 2 intervention sessions per week during initial 6-month phase;

Exclusion criteria

• Contraindication to weight loss

  • Receiving active cancer treatment (radiation/chemotherapy)
  • Liver failure
  • History of anorexia nervosa;
• Cardiovascular event (unstable angina, myocardial infarction) within previous 6 months;
• Prior or planned bariatric surgery;

Use of prescription weight loss medication or over-the-counter orlistat within 3 months

if participant does not agree to stop taking it;

• Twenty pound or greater weight loss in 3 months prior to baseline, as documented by staff measurement;
• Inability to walk to participate in exercise class;
• Pregnant or planning a pregnancy during study period. Nursing mothers would need approval from physician;
• Alcohol or substance use disorder either: 1) active and determined to be incompatible with participation in the intervention through discussion with program staff; or 2) new abstinence from alcohol or substance use disorder in past 30 days;
• Planning to leave rehabilitation center within 6 months or move out of geographic area within 18 months;
• Investigator judgment (e.g., for concerns over safety, adherence or follow-up);
• Weight greater than 400 pounds.