A structured lifestyle intervention to reduce cardiometabolic risk factors in individuals with obsessive-compulsive disorder: feasibility trial.

Background: Obsessive-compulsive disorder (OCD) is associated with an increased risk of cardiometabolic disorders. We developed a lifestyle intervention, named LIFT, aimed at improving lifestyle habits (physical activity, diet, alcohol and tobacco use, stress, sleep) and reducing cardiometabolic risk factors in OCD.

Aims: This study aimed to establish the feasibility and acceptability of LIFT, evaluate its preliminary efficacy and explore experiences of participation.

Method: Individuals with OCD and at least three cardiometabolic risk factors (e.g. physical inactivity, unhealthy diet, overweight/obesity, dyslipidaemia) were offered LIFT, consisting of one individual session to set individual goals, six educational group sessions and 12 exercise group sessions, delivered over 3 months. We collected baseline, post-intervention and 3-month follow-up measures. Preliminary efficacy variables were analysed with linear mixed models and within-group effect sizes. Qualitative interviews were conducted.

Results: Out of 147 screened individuals, 25 were included (68% women, mean age 37.4, s.d. = 10.9). Credibility and satisfaction were high, attrition rates were low (16%) and the programme was generally safe. Recruitment and adherence to the intervention were challenging. Statistically significant improvements were observed in dietary habits, alcohol consumption, stress, OCD symptom severity and general functioning (within-group effect sizes ranging from 0.27 to 0.56). No changes were observed in physical activity, sleep or any physiological or laboratory measures.

Conclusions: Overall, LIFT was a feasible intervention for individuals with OCD. Effects on lifestyle habits, mental health and functioning are promising. Fully powered randomised controlled trials are needed to evaluate its efficacy and cost-effectiveness.