Abstract
BackgroundNational Institute for Health and Care Excellence (NICE) guidance on adult weight management recommends interventions are multi-component. We aimed to assess the implementation and health benefits of a primary care referral to an adult multi-component weight management intervention in a community setting. The intervention was offered through Primary care in National Health Service (NHS) South Gloucestershire, UK, from Oct 2008 to Nov 2010, in partnership with statutory, community and commercial providers. The scheme offered 12 weeks’ community based concurrent support of dietary (Weight Watchers, WW), physical activity (Exercise on Prescription, EOP) and behavioural change (motivational interviewing) components to obese adults. Funding was available for 600 places.ResultsFive hundred and fifty nine participants engaged with the intervention, mean age 48 years, 88 % female. Mean weight loss for all engagers was 3.7 kg (95 % confidence interval 3.4, 4.1). Participants completing the intervention achieved the largest weight reduction (mean loss 5.9 kg; 5.3, 6.6). Achievement of 5 % weight loss was higher in completers (58 %; 50, 65) compared to non-completers (19 %; 12, 26) and people who only participated in one commercial component of the intervention (either WW or EOP; 19 %; 13, 24).ConclusionA multi-component weight management programme may be beneficial for weight loss, but a randomized controlled trial is needed to establish effectiveness and to evaluate cost.
Highlights
National Institute for Health and Care Excellence (NICE) guidance on adult weight management recommends interventions are multi-component
At least 10 million UK adults are eligible for weight management interventions to reduce their risk of morbidity and mortality [1] and thousands of patients are identified daily through National Health Service (NHS) initiatives for obesity, cardiovascular management and diabetes prevention
Recruitment of participants Participants were referred into the scheme from 18 of 22 general practices that adopted the intervention in the South Gloucestershire region of England
Summary
National Institute for Health and Care Excellence (NICE) guidance on adult weight management recommends interventions are multi-component. We aimed to assess the implementation and health benefits of a primary care referral to an adult multi-component weight management intervention in a community setting. The scheme offered 12 weeks’ community based concurrent support of dietary (Weight Watchers, WW), physical activity (Exercise on Prescription, EOP) and behavioural change (motivational interviewing) components to obese adults. A primary route to weight loss is to achieve a negative energy balance (expending more calories than are consumed) This can be achieved by reducing dietary calorific intake or increasing physical activity or both. Diet and physical activity behaviours are both amenable to change and National Institute for Health and Care Excellence (NICE) guidelines state that multi-component lifestyle
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