The Effect of a Brief Low-Intensity Therapeutic Lifestyle Counselling Intervention on Weight Loss among Overweight Patients in Primary Care: A Pilot Randomised Controlled Trial

Abstract

Introduction: To preliminarily assess the effectiveness of a simple low intensity therapeutic lifestyle counselling intervention on weight reduction in overweight patients in primary care. Methods: We piloted a six-month randomised controlled trial on 200 primary care clinic patients aged between 21 to 75 years with body mass index (BMI) >23 kg/m2 who were randomised into two groups. The intervention group received a structured intervention consisting of a 15-minute education session on calorie content of common local food items, healthy food choices, exercise frequency, intensity, type, and time duration, and weight reduction goal setting; the control group received usual care. The primary outcome measure was change in body mass index (BMI) from recruitment to 6 months. Results: Five hundred and seventeen out of the 1,304 patients assessed were eligible for the study. Of these, 317 declined to participate (61.3%). Among the 200 who participated, 88 were assigned to usual care and 112 were assigned to intervention. Only 62 participants completed the six-month follow-up (24 in control and 38 in intervention group). The mean BMI decline was greater in the intervention than control group [0.71 (SD=1.17) and 0.08 (SD=0.90) kg/m2 respectively, p=0.021], and remained statistically significant after adjusting for age, gender and baseline BMI (p=0.041). Conclusion: Our pilot study found that a simple six-month low-intensity therapeutic lifestyle counselling intervention resulted in statistically significant but small reductions in BMI in overweight patients in primary care. These results should be interpreted with caution due to high participation refusal and lost-to-follow-up rates, and lack of objective process measures.