Evaluation of obesity service outcomes in structured lifestyle weight management clinics at 6, 9 and 12 months

Abstract

Background: Obesity remains a global epidemic and the effectiveness of weight loss interventions are constantly scrutinised. Hickson et al. (2009) concluded that specific weight loss clinics may achieve better weight loss results and therefore a better use of dietetic time then including obese patients in a general setting. A comparison of local structured weight management clinics versus general clinics was undertaken in 2010, with the conclusion that structured clinics achieve a greater mean weight loss and percentage weight loss then conventional dietetic clinics. This evaluation aimed at further assessing the effectiveness of these clinics with a focus on weight maintenance outcomes at 9 and 12 months. Methods: CLCH Dietetic Service offers a structured Lifestyle Weight Management (LWM) clinic (6 monthly appointments with reviews at 9 and 12 months). LWM outcomes were routinely collected on a central database and these data were used for comparison. These clinics aimed for ≥5% weight loss in 6 months with sustained maintenance. Patients completing the initial 6-month LWM intervention (attending at least four of the six appointments) between April 2009 and December 2010 were included. Those that were due and attended the 9- and 12-month reviews were assessed for weight maintenance; however, as a result of the staggered start dates of attendees, not all patients included in the 6-month results have completed these reviews. Results: Twenty-four patients completed the initial 6 months and, of those, 20 (83%) lost weight. After the initial 6 months, a mean weight loss and percentage weight loss of 6.2 kg and 5.5%, respectively, was achieved. Twelve of the 15 patients due for review attended at 9 months with 11 (92%) maintaining their weight loss. Ten patients were expecting their final 12-month review by December 2010 (42% of the initial 24 patients) of which seven attended and six (86%) maintained a level of weight loss. Table 1. Effect of the lifestyle weight management clinic on weight loss, body mass index (BMI) and waist circumference after 6, 9 and 12 months Results 6 months 9 months 12 months Mean weight loss (kg) 6.2 (0.6–16.5) 7.2 (1.1–17) 5.1 (1.5–13.1) Mean weight loss % 5.5 (1–14) 5.7 (0.9–13.1) 4.1 (1.3–10) Mean waist circumference loss (cm) 5.7 (1–9.5) 5.4 (3–11) 4 (2.5–6) Mean BMI loss (kg m−2) 2.1 (0.2–5.6) 2.1 (0.6–6) 1.7 (0.6–3.7) Discussion: These data demonstrates that LWM clinics achieve the aimed weight loss targets at 6 months. It is well documented that 5–10% weight loss can significantly improve health outcomes (Scottish Intercollegiate Guidelines Network, 2010). This weight loss was maintained at the 9-month review by 92% of those that attended; however, between the 9- and 12-month reviews, this weight loss decreased indicating weight regain over this period. Continued evaluation is required and consideration of support services between the 9- and 12-month review is needed to ensure ongoing weight maintenance. Conclusions: These results provide evidence that LWM clinics achieve the desired outcomes and maintenance of weight loss in those who successfully attended the LWM clinics is achievable.