Abstract

Objective: There is limited evidence on the prevalence of patients’ obesity-related co-morbidities and the effectiveness of specialist multidisciplinary weight management (Tier 3) programmes prior to bariatric surgery. We therefore evaluate and report the prevalence of co-morbidities in patients attending a Tier 3 service within the National Health Service.Methods: This was a prospective observational study of consecutive patients who attended the Tier 3 service at the East Midlands Bariatric Metabolic Institute throughout 2017.Results: 430 patients attended the service over the study observation period. Twelve patients (2.8%) were excluded from our analysis due to incomplete data. 70.8% of patients were women, mean age at baseline was 46.4 years, mean±SD weight and body mass index at baseline were 137.8±29.2 kg and 48.0±8.6 kg/m2, respectively. The most common co-morbidities recorded at baseline were type 2 diabetes mellitus (31.1%), hypertension (31.1%), depression (26.1%), obstructive sleep apnoea (23.2%) and osteoarthritis (15.6%). Significant weight loss was observed at the 3-month and 6-month follow-up points, but not at the 9- or 12-month follow-up points. 22.5% of patients achieved weight loss of ≥5%.Conclusion: The prevalence of co-morbidities within this Tier 3 service was high. While specialised weight management services may achieve moderate weight loss through a multidisciplinary intervention, future evaluation of clinical outcomes of specialist weight services should also include co-morbidity outcomes.

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