Feature Article

Metabolic disease in mental illness: exercise as medicine

Feature Article

Metabolic disease in mental illness: exercise as medicine

Devlin Higgins, Roger Chen

Figures

© gilaxia/istockphoto.com models used for illustrative purposes only
© gilaxia/istockphoto.com models used for illustrative purposes only

Abstract

Individuals living with mental illness have high rates of premature cardiometabolic disease. Reasons for this are complex but may include adverse effects of medications, such as antipsychotics, and poor access to physical health care. Incorporating regular physical activity as part of treatment for people with mental illness can help reduce cardiometabolic disease. General practitioners can play a key role in co-ordinating the appropriate services and referrals for such patients.

Key Points

  • People with mental illness have poorer health outcomes than the general population and are at higher risk of developing cardiometabolic disease, including diabetes, prediabetes, metabolic syndrome, obesity and premature cardiovascular diseases.
  • Low levels of physical activity, adverse effects of atypical antipsychotic medications and factors, such as diet, health literacy and access to health care, affect physical health outcomes of people with mental illness.
  • Increasing physical activity can benefit cardiometabolic outcomes and may improve symptoms of mental illness.
  • The traditional separation of mental and physical health care and lack of referral pathways for people with mental illness should therefore be challenged across all healthcare settings.
  • Individualised exercise programs for patients with mental illness, taking into account the patient’s motivation and preferred exercise and activity level, can help patients reach their exercise goals and maximise the benefits of physical activity.
  • Some referral options to private and community-based exercise professionals and programs may be Medicare- rebatable and should be considered in the management of patients with mental illness who are at risk of metabolic disease.