“Housing First” approach to finding housing for homeless people with mental illness has no significant impact on obesity

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“Housing First” approach to finding housing for homeless people with mental illness has no significant impact on obesity

Toronto, September 29, 2015

By Leslie Shepherd

Dr. Stephen Hwang
Dr. Stephen Hwang

The “Housing First” approach of giving homeless people with mental illness a place to live without any preconditions such as sobriety or enrollment in a psychiatric treatment program has many benefits. But losing weight isn’t one of them.

People experiencing homelessness have high rates of overweight and obesity, which are associated with increased risk of poor health, many chronic diseases and premature death.

Researchers at St. Michael’s Hospital wondered if having stable housing would lead to weight loss since access to housing means people have the opportunity to buy, store and prepare food of higher nutritional value than they would previously have had. In addition, making the transition to stable housing may be part of an entire lifestyle modification that includes healthier eating.

But their findings, published today in the journal PLOS ONE, found that was not the case.

Neither the Body Mass Index nor the waistline circumference of people involved in their study changed significantly over 24 months.

Senior author Dr. Stephen Hwang, director of the hospital’s Centre for Research on Inner City Health, said the people involved in the study all had serious mental illness and if they started a treatment program they could have been prescribed psychotropic drugs that can result in weight gain or loss. Changes in drug and alcohol use can do the same.

“Our findings suggest we need a better understanding of factors contributing to overweight, obesity and high waist circumference in people who have a history of precarious housing and poverty as well as other concerns such as mental illness and additions,” Dr. Hwang said.

Co-author Dr. Julia Woodhall-Melnik researchers also need to look critically at the nutritional content of food provided through hot meal programs and food banks.

This study involved data from 575 people enrolled in the Toronto site of the Mental Health Commission of Canada’s At Home/Chez Soi, a research project that evaluated a “housing first” approach, where people are first provided with a place to live, without preconditions such as sobriety or seeing a psychiatrist, and then provided additional supports and services as needed. The underlying principle is that people are better able to move forward with their lives if they are first housed.

This study received funding from Health Canada.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

Media contacts

For more information, or to arrange an interview with Dr. Hwang, please contact:

Leslie Shepherd
Manager, Media Strategy, St. Michael's Hospital

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