New research from the University of Oxford, supported by the Oxford Health Biomedical Research Centre’s (OH BRC) Preventing Multiple Morbidities Theme, has found that people with severe mental illness (SMI) gain 4kg more weight than peers over 15 years but aren’t offered more weight-management support.
The research, published in The Lancet Psychiatry, tracked 113,904 adults (including 23,025 with SMI matched to 90,879 without) across 1,454 GP practices. People with SMI gained 5.6kg compared to 1.6kg in those without by year 15.
After accounting for factors including age, sex, race and ethnicity, socioeconomic status, alcohol consumption, smoking status, and BMI, people with SMI and a BMI of 25 kg/m² or higher were 10% more likely than people without SMI to receive weight management advice from GPs. However, they were no more likely to be referred to structured weight management programmes, highlighting a significant gap between problem recognition and service provision.
The findings directly support priorities in the NHS 10 Year Health Plan, particularly its focus on prevention, shifting care from hospital to community through the Neighbourhood Health Service, and addressing health inequalities. People with SMI die on average 15 years earlier than the general population, largely due to preventable cardiovascular disease. Excess weight is a key driver of this health inequality, often worsened by antipsychotic medications essential for managing symptoms.
