At least once a week Dr. Rohan Ganguli meets with a select group of clients at Toronto’s Centre for Addiction and Mental Health (CAMH) who live each day with two critical health challenges: mental illness and diabetes.
At these meetings Dr. Ganguli, a professor of psychiatry and Canada Research Chair at the University of Toronto’s Dalla Lana School of Public Health, reviews diaries that record levels of physical activity and daily diet, and discusses the small, everyday choices that people with diabetes can make to improve their health and manage their disease better.
“We started by encouraging people to self-monitor, using pedometers we gave them so they can record how much they're walking and a scale they got to keep at home so they can weigh themselves every day,” explains Dr. Ganguli, who is also a senior scientist at CAMH. “They keep a paper diary – most people I’m dealing with are poor and can’t afford a computer or mobile device – and during our meetings we go over the diaries with them, and the people in the group share their experiences and support each other.”
Dr. Ganguli’s work with this particular group of clients is part of a three-year study looking at whether an intense behavioural weight-loss intervention can help people with mental health challenges and diabetes. Funded by the Canadian Diabetes Association and the Public Health Agency of Canada, the study involves about 70 participants, with two-thirds getting intervention and one-third getting encouragement to make changes – such as losing weight – during monthly discussions with Dr. Ganguli and his research team.
So far, says Dr. Ganguli, six-month results have shown about 400 per cent more clinically significant weight loss among the participants getting weekly intervention than those who are not.
“Some people who are not getting intervention have lost a bit of weight,” says Dr. Ganguli. “But we’re seeing much more weight loss in people who are in the group getting intervention.”
Diabetes is a serious concern among Canadians with mental health challenges, says Dr. Ganguli. The rate of diabetes among people with serious mental illnesses is two to three times higher than among the general population. At the same time, life expectancy among this group is generally lower by about five to 15 years.
There are a number of factors behind the higher incidence of diabetes among Canadians facing mental health challenges, including lack of access to healthy foods, little or no opportunities for physical activity, and in some cases medications for mental illness that may cause weight gain.
“Diet and physical activity are the two key factors that determine the incidence of diabetes within a given population,” says Dr. Ganguli. “What we are trying to do is determine whether we can change lifestyle patterns within this particular population or subgroup.”