One size fits none: theorizing weight management in the everyday lives of adults with serious mental illness

Restricted until 05 Aug. 2012.Weight management problems pose a grave threat to the health and well-being of adults with serious mental illness. In fact, overweight and obesity rates for this population are estimated to be up to twice that of the general populace. Despite the urgent need to address this issue, few studies have been undertaken to develop effective interventions tailored to the specific life circumstances implicated in the poor weight management of this group.; The present study constituted a first step for the future development of an intervention designed to enable better weight management in adults with serious mental illness. Using an overarching disability studies conceptual framework, I employed qualitative research methods to discern the complexity of life circumstances and factors that influenced weight management difficulties for these individuals. I reasoned that by developing a detailed understanding of the particular dilemmas these adults had in managing their weight in everyday life, I would subsequently be able to develop an effective intervention approach. Fourteen participants engaged in focus group interviews with a subset of four participants taking part in individual semi-structured interviews and activity visits. On the basis of data generated, four overarching domains of concern related to weight management emerged, including: (a) addressing physical health issues, (b) maintaining psychological well-being and managing stigma, (c) engaging in valued activities and connecting with others, and (d) providing for everyday needs. Additionally, eleven interrelated subdomains were identified through which the problem areas could be redressed.; This four-pronged typology with its associated subdomains provides a data-driven conceptual foundation for the future development of a Lifestyle Redesign® weight management intervention for adults with serious mental illness. The findings revealed that macro-level sociopolitical and socioeconomic factors permeated the weight management experiences of this population. As such, it became clear that the intervention approach to be developed must incorporate system change strategies relative to the lifestyle domains that comprised the typology