Service evaluation of a pilot psychology clinic including psychological intervention within a Tier 2 community adult weight management service

Abstract

Background:Obesity levels in Scotland are amongst the highest in the developing world and psychological co-morbidities are common amongst the obese population. and evidence suggests that psychological approaches, can result in sustained weight loss, improved wellbeing and reduced binge eating. However, there is limited evidence of effective intervention supporting weight outcomes in a general setting.Aim:The aim of this pilot intervention was to determine if the addition of a psychology clinic within a Tier 2 community adult weight management service (CAWMS) supported positive weight management outcomes.Methods:Service evaluation data was gathered at an urban and rural GP practice within Grampian. Patients were referred to the pilot psychology clinic if mild to moderate mental health concerns were highlighted. Eight patients (average age 46 years; mean BMI 46.2) attended between four and eight appointments within the psychology clinic. Progress, goal setting, barriers and relapse prevention were discussed using a motivational interviewing approach. Psycho-education, self-management advice and brief psychological interventions, were offered where appropriate.Results:Mean weight loss for patients who attended the psychology clinic was 7.4kg. Mean HADS anxiety scores did not change, whereas HADS depression scores reduced by 3.5, although not statistically significant (p > 0.001). Qualitative feedback suggests that the majority of patients found the addition of psychological support helpful.Conclusion:The pilot has highlighted the value and importance of a psychology clinic within Tier 2 CAWMS. Feedback from dietitians suggests that the addition of psychological support better informed their understanding of patients concerns. It highlights the need for ‘joined-up’ working within the community weight management service.