Researchers looked at 31 studies to see if working with nutrition experts and fitness professionals could help people with serious mental illnesses like schizophrenia and bipolar disorder improve their physical health. They found that when people received help with both diet and exercise together, they lost weight and reduced their waist size. When people only got nutrition help, their blood pressure improved. These findings suggest that adding specialized nutrition and exercise programs to regular mental health care could help people with serious mental illness live healthier lives overall.

The Quick Take

  • What they studied: Whether working with dietitians, nutritionists, and exercise professionals could help people with serious mental illnesses improve their weight, blood pressure, and other physical health markers
  • Who participated: 31 different research studies involving people diagnosed with severe mental illnesses like schizophrenia, bipolar disorder, and major depression. The studies tested three types of help: diet plus exercise together, diet alone, or exercise alone
  • Key finding: People who received both diet and exercise help from specialists lost an average of about 2 pounds and reduced their waist size by about 1.6 inches. People who got only nutrition help saw their blood pressure drop by about 6 points
  • What it means for you: If you or someone you know has a serious mental illness, adding specialized nutrition and exercise support to regular mental health treatment may help improve weight and blood pressure. However, talk with your doctor before starting any new program, as results vary by person

The Research Details

Researchers searched five major medical databases for all studies published through August 2024 that tested whether specialists (like registered dietitians and certified fitness professionals) could help people with serious mental illnesses improve their physical health. They only included studies that compared people who received this specialized help to people who didn’t receive it, or compared different types of help.

The researchers then combined the results from 23 of the 31 studies using a technique called meta-analysis, which allows them to see patterns across many studies at once. They looked at three different approaches: combining diet and exercise help, diet help alone, and exercise help alone. They measured changes in weight, waist size, blood pressure, and other health markers related to heart disease and diabetes risk.

This research approach is important because people with serious mental illnesses often face extra challenges with physical health—they may gain weight, develop high blood pressure, or have heart disease risk factors. By looking at many studies together, researchers can see whether specialist-delivered programs actually work and how much they help. This gives doctors and patients better information for deciding whether to add these programs to regular mental health care.

This is a systematic review and meta-analysis, which is considered one of the strongest types of research evidence. The researchers searched multiple databases to find all relevant studies and used clear rules for deciding which studies to include. However, the individual studies they reviewed varied in quality and size, which means some results are more reliable than others. The fact that combined diet and exercise showed clearer benefits than exercise alone suggests the findings are meaningful, but more research is still needed

What the Results Show

When people with serious mental illnesses received both diet and exercise help from specialists, they experienced measurable improvements. On average, they lost about 2 pounds and reduced their waist circumference by about 1.6 inches. These changes happened over weeks to months of the programs studied.

When people received only nutrition help from specialists, their systolic blood pressure (the top number in a blood pressure reading) dropped by about 6 points on average. This is a meaningful improvement, as even small reductions in blood pressure can lower the risk of heart disease and stroke.

Interestingly, studies that tested exercise alone did not show significant improvements in the measured health markers. This doesn’t mean exercise isn’t helpful—it may mean that exercise alone without nutrition guidance wasn’t enough to create measurable changes in the short to medium term, or that the studies weren’t designed to capture all the benefits of exercise.

The research suggests that having a specialist guide the process is important. When people worked directly with dietitians, nutritionists, or certified exercise professionals rather than just receiving general advice, they were more likely to see results. The improvements were most consistent when programs combined both nutrition and exercise, suggesting these two approaches work better together than separately.

This research builds on earlier studies showing that people with serious mental illnesses often struggle with weight gain and heart disease risk factors, sometimes due to medications they take. Previous research suggested that lifestyle programs might help, but this is one of the first comprehensive reviews showing that specialist-delivered programs actually do work. The findings support what many mental health experts have been recommending but now with stronger evidence behind it.

The studies reviewed varied quite a bit in how they were designed and how long they lasted, which makes it harder to draw firm conclusions. Most programs lasted only a few weeks to months, so we don’t know if the benefits last longer. The studies didn’t always measure the same things, making comparisons difficult. Also, people who volunteer for these programs might be more motivated than the general population with serious mental illness, so results might not apply to everyone. Finally, the research didn’t look at whether these programs help people feel better mentally or improve their quality of life—only physical health markers

The Bottom Line

If you have a serious mental illness, ask your doctor or mental health provider about adding a specialist-delivered nutrition and exercise program to your care. Look for programs that include both components and are led by registered dietitians or certified exercise professionals. Start slowly and set realistic goals. These programs appear most effective when combined with your regular mental health treatment, not as a replacement for it. Confidence level: Moderate—the evidence is promising but more research is needed

This research is most relevant for people with serious mental illnesses like schizophrenia, bipolar disorder, or major depression who are concerned about their weight or heart disease risk. It’s also important for mental health providers, psychiatrists, and healthcare systems deciding whether to offer these programs. Family members supporting someone with serious mental illness may also find this helpful. People with mild to moderate mental health conditions may benefit, but this research specifically studied severe mental illness

Based on the studies reviewed, you can expect to see measurable changes in weight and waist size within 8-12 weeks of starting a combined nutrition and exercise program. Blood pressure improvements may appear within similar timeframes. However, these are averages—some people see changes faster, others slower. It typically takes 3-6 months to see if a program is working for you personally

Want to Apply This Research?

  • Track weekly weight and waist circumference measurements, plus blood pressure readings if you have a monitor. Record which nutrition and exercise activities you completed each week. This creates a clear picture of progress over 8-12 weeks
  • Set one specific nutrition goal (like adding one vegetable to dinner daily) and one exercise goal (like a 15-minute walk three times weekly) each week. Use the app to log completion and celebrate small wins. Connect with a registered dietitian or exercise professional through your healthcare provider for personalized guidance
  • Check in monthly with your healthcare provider to review your progress. Use the app to share your tracking data with them. If you’re not seeing changes after 8-12 weeks, discuss adjustments with your specialist. Continue tracking even after reaching goals to maintain improvements

This research summary is for educational purposes only and should not replace professional medical advice. If you have a serious mental illness, always consult with your psychiatrist, doctor, or mental health provider before starting any new nutrition or exercise program. Some medications used to treat serious mental illnesses can affect weight and metabolism, so personalized medical guidance is essential. This research does not suggest that nutrition and exercise can replace psychiatric medications or therapy. Results vary by individual, and what works for one person may not work for another.