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Abstract
SummaryBackgroundNHS England has recommended a multidisciplinary weight management services (MWMS—Tier 3 services) for patients requiring specialized management of obesity, including bariatric surgery, but clinical and measurable health‐related outcomes from these services remains fragmented. We therefore undertook a systematic review to explore the evidence base of effect on body weight loss and comorbidities outcomes of Tier 3 or UK pre‐bariatric MWMPs.MethodsAMED, CINAHL, EMBASE, HMIC, MEDLINE, PsycINFO, PubMed, HDAS search and Google Scholar were searched from January 2000 to September 2017 in a free‐text fashion and crossed‐references of included studies to identify potential illegibility. Inclusion criteria were as follows: (a) published Tier 3 original study abstracts/articles; (b) intervention studies with before and after data; (c) studies that included any sort of MWMPs conducted on British residents with obesity; and (d) studies included T2DM measurements in a MWMPs.ResultsIn total, 19 studies met the inclusion criteria. The total number of participants analysed was N = 11,735. Baseline accumulative average BMI was calculated at 42.54 kg/m2, weight 117.88 kg and waist circumference 126.9 cm. And at 6 months, 40.73 kg/m2, 112.17 kg and 120.3 cm, respectively. Secondary outcome variables were as improved with reduction in HbA1c, fasting blood sugars, insulin usage and blood pressure. Physical activity increased at 3 months then declined after 6 months with no significant changes in cholesterol levels.ConclusionTier 3 and MWMPs have a short to mid‐ranged positive effect on obese patients (BMI ≥30 kg/m2) living in the UK regarding accumulated reduction in weight, glycaemic control, blood pressure and with subtle improvements in physical activity.
Highlights
Morbid obesity is an increasing lifelong chronic condition that no country has yet succeeded to tackle.[1]
McKinsey Global Institute reported that, second to smoking, obesity has the largest impact on the public health budget with an estimated annual cost to the United Kingdom’s (UK) National Health Service (NHS) of £44.7b
We evaluated each of the included studies and extracted four data aspects: (a) descriptive to study design and intervention (Table S1); (b) sample size and demographic characteristics (Table S2); (c) as‐ sessed measurements (Table S3); and (d) health outcome records at baseline followed by points of time intervals (Tables S4‐S9)
Summary
Morbid obesity is an increasing lifelong chronic condition that no country has yet succeeded to tackle.[1] In England, the prevalence of obesity is among the highest in Europe.[2] Two‐thirds of adults are overweight and one in four are obese (Body Mass Index (BMI) of >30 kg/m2).[3,4] McKinsey Global Institute reported that, second to smoking, obesity has the largest impact on the public health budget with an estimated annual cost to the United Kingdom’s (UK) National Health Service (NHS) of £44.7b.5. The importance of a range of obe‐ sity prevention initiatives comes from the increasing number of health complications and their related high cost. High Blood Pressure (BP), type 2 diabetes mellitus (T2DM), heart attacks, strokes, cancers and other health issues, for instance, are associated to the conditions of being overweight or obese.[4]
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