Efficacy and cost-effectiveness of a structured lifestyle intervention to reduce cardiometabolic risk in Obsessive-Compulsive Disorder

Is a lifestyle intervention for individuals with OCD feasible and efficacious in reducing cardiovascular risk? In this project, we will adapt and evaluate an existing evidence-based lifestyle intervention following a two-stage approach.


Individuals with psychiatric disorders, including those with obsessive-compulsive disorder (OCD), have substantially reduced lifespans.

In a previous FORTE-funded project (ref. 2015-00569) using data from the Swedish registers, we established that individuals with OCD, a prevalent and impairing mental disorder, are at substantially increased risk of metabolic and cardiovascular disorders, including a 57% increased risk of obesity, 42% increased risk of circulatory system diseases, and 21% increased risk of type 2 diabetes, compared to the general population.

We also established that this risk, rather than being linked to shared familial factors or medication for their OCD, is likely to be a consequence of the OCD itself.

Therefore, it is crucial to consider the lifestyle habits (e.g., physical activity, diet) of individuals with OCD that may be responsible for the observed metabolic and cardiovascular complications and are known to be amenable to modification.

Surveyed members of the Svenska OCD-förbundet support the development of lifestyle interventions as an important complement to existing evidence-based treatments for the disorder.

In this project, we will adapt and evaluate an existing evidence-based lifestyle intervention following a two-stage approach.

First, we will work with the Svenska OCD-förbundet to adapt the intervention to the needs of OCD patients and will conduct a pilot study to evaluate if the intervention is feasible, safe, and acceptable for the patients. Second, we will conduct a fully powered randomized controlled trial to establish the efficacy and cost-effectiveness of this intervention. If successful, we aim to implement the intervention in routine clinical care.


  1. To adapt an existing lifestyle intervention to reduce cardiometabolic risk to suit the specific needs of individuals with OCD, in close collaboration with the Svenska OCD-förbundet.
  2. To evaluate the feasibility, acceptability, and safety of the intervention in a pilot study.
  3. To conduct a randomized controlled trial to examine the efficacy and cost-effectiveness of the intervention, compared to medical advice only and treatment as usual (TAU).


FORTE - 1 January 2020 - 31 December 2022


  • Alcohol
  • Diet
  • Oral health
  • Sleep
  • Smoking
  • Stress
  • Physical activity


  • Cardiovascular diseases
  • Psychiatric conditions


  • RCT

The plan is to conduct a pilot study followed by an RCT.


  • Patients


  • Both


  • Adults 18 to 50 years old
  • Patients over 50 years old

Key words

  • Obsessive-compulsive disorder
  • Psychiatric disorders
  • Metabolic syndrome
  • Cardiovascular risk
  • Lifestyle interventions



Metabolic and Cardiovascular Complications in Obsessive-Compulsive Disorder: A Total Population, Sibling Comparison Study With Long-Term Follow-up.
Isomura K, Brander G, Chang Z, Kuja-Halkola R, Rück C, Hellner C, et al
Biol. Psychiatry 2018 09;84(5):324-331

Long-term effects on cardiovascular risk of a structured multidisciplinary lifestyle program in clinical practice.
Lidin M, Hellénius ML, Rydell-Karlsson M, Ekblom-Bak E
BMC Cardiovasc Disord 2018 04;18(1):59

Long-term effects of a Swedish lifestyle intervention programme on lifestyle habits and quality of life in people with increased cardiovascular risk.
Lidin M, Ekblom-Bak E, Rydell Karlsson M, Hellénius ML
Scand J Public Health 2018 Aug;46(6):613-622

Collaborating partners

GHS, Karolinska University Hospital


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Lorena Fernandez De La Cruz

Senior researcher, Principal investigator