Commercial Weight Management Programme Research Articles

Changes in Self-esteem in Participants Associated with Weightloss and Maintenance of Commercial Weight Management Programme

Introduction and methods: This study examined associations between weight loss, its maintenance and self-esteem in 292 members of a commercial weight management organisation, Slimming World. Self-esteem was measured with the Rosenberg self-esteem questionnaire adapted to 5-point Likert scales. Associations between dimensions of self-esteem and weight change were examined by correlation and regression using the GENSTAT 5 statistical program. Results: Mean (SD) weight on joining the CWMO was 89.0 (20.0) kg; time taken to reach current weight was 16.3 (13.5) months. Mean (SD) weight change was -15.6 (11.4) kg and BMI change was -5.7 (4.0) (both p < 0.001), maintained for 11.7 (12.8) months. Percent variance in weight change associated with each component of self-esteem is given in parentheses. All weight changes were negative. Participants reported a decrease in sense of failure (3.9%) and an increase in self-respect (3.0%) and self-pride (2.4%). Self-satisfaction (12.8%), feelings of self-achievement (10.6%), positive attitudes towards themselves (9.9%), sense of self-worth (10.6%) and self-efficacy (7.3%) all significantly increased in association with reaching and maintaining their current weight (all p < 0.001). Multiple regression analysis showed that age, gender, height and start weight accounted for 35.4% of the variance in weight change. Self-esteem components of the model accounted for 50.4% of the variance in weight change. Conclusion: Successful weight loss and maintenance was associated with significant reported improvements in self-esteem in members of a Commercial Weight Management Organisation.

Experiences of a commercial weight-loss programme after primary care referral: a qualitative study.

BackgroundReferral to a commercial weight-loss programme is a cost-effective intervention that is already used within the NHS. Qualitative research suggests this community-based, non-medical intervention accords with participants’ view of weight management as a lifestyle issue.AimTo examine the ways in which participants’ attitudes and beliefs about accessing a commercial weight management programme via their doctor relate to their weight-loss experience, and to understand how these contextual factors influence motivation and adherence to the intervention.Design and settingA qualitative study embedded in a randomised controlled trial evaluating primary care referral to a commercial weight-loss programme in adults who are overweight or obese in England. The study took place from June–September 2013.MethodTwenty-nine participants (body mass index [BMI] ≥28 kg/m2; age ≥18 years), who took part in the WRAP (Weight Loss Referrals for Adults in Primary Care) trial, were recruited at their 3-month assessment appointment to participate in a semi-structured interview about their experience of the intervention and weight management more generally. Interviews were audiorecorded, transcribed verbatim, and analysed inductively using a narrative approach.ResultsAlthough participants view the lifestyle-based, non-medical commercial programme as an appropriate intervention for weight management, the referral from the GP and subsequent clinical assessments frame their experience of the intervention as medically pertinent with clear health benefits.ConclusionReferral by the GP and follow-up assessment appointments were integral to participant experiences of the intervention, and could be adapted for use in general practice potentially to augment treatment effects.

Preventing Breast Cancer Recurrence through a Tailored Lifestyle Intervention: The MyLIFE (My Lifestyle Intervention with Food and Exercise) Trial Rationale and Study Design

Breast cancer risk, and risk of associated co-morbidities such as cardiovascular disease, is highest among overweight or obese women with a previous history of breast cancer. The objective of this study is to test the effectiveness of a tailored nutrition, physical activity, and behavioral weight management intervention for breast cancer survivors against a widely available commercial weight management program. We hypothesize that an intervention tailored to the unique psychological, nutritional, and physical needs of breast cancer survivors will provide superior physiological and psychological benefits compared to an existing commercial program for the general population. To test our hypothesis, we initially conducted a focus group with both breast cancer survivors and oncology affiliated health care providers in order to illicit feedback to develop an intervention customized specifically to breast cancer survivors. Subsequently, in a randomized, multicenter trial, we are studying the effect of the tailored program on overweight/obese women (N=120) with a history of breast cancer (3 months to 5 years post-primary treatment) on body weight and composition, markers of systemic inflammation related to cancer and associated chronic diseases, physical activity habits, dietary intake, health-related quality of life, and program adherence and satisfaction. Assessments will be taken prior to study initiation immediately following the intervention and at 6 months post-intervention to assess long-term maintenance of weight, lifestyle behaviors, and impact on physiological markers of disease risk. This project is unique in that it addresses weight issues in a high risk, understudied population using a tailored approach.

Behavioural weight management programmes for adults assessed by trials conducted in everyday contexts: systematic review and meta-analysis.

This systematic review and meta-analysis of effectiveness trials comparing multicomponent behavioural weight management programmes with controls in overweight and obese adults set out to determine the effectiveness of these interventions implemented in routine practice. To be included, interventions must have been multicomponent, delivered by the therapists who would deliver the intervention in routine practice and in that same context, and must be widely available or feasible to implement with little additional infrastructure or staffing. Searches of electronic databases were conducted, and augmented by screening reference lists and contacting experts (November 2012). Data were extracted by two reviewers, with mean difference between intervention and control for 12-month change in weight, blood pressure, lipids and glucose calculated using baseline observation carried forward. Data were also extracted on adverse events, quality of life and mood measures. Although there were many published efficacy trials, only eight effectiveness trials met the inclusion criteria. Pooled results from five study arms providing access to commercial weight management programmes detected significant weight loss at 12 months (mean difference −2.22 kg, 95% confidence interval [CI] −2.90 to −1.54). Results from two arms of a study testing a commercial programme providing meal replacements also detected significant weight loss (mean difference −6.83 kg, 95% CI −8.39 to −5.26). In contrast, pooled results from five interventions delivered by primary care teams showed no evidence of an effect on weight (mean difference −0.45 kg, 95% CI −1.34 to 0.43). One study testing an interactive web-based intervention detected a significant effect in favour of the intervention at 12 months, but the study was judged to be at high risk of bias and the effect did not persist at 18 months. Few studies reported other outcomes, limiting comparisons between interventions. Few trials have examined the effectiveness of behavioural weight loss programmes delivered in everyday contexts. These trials suggest that commercial interventions delivered in the community are effective for achieving weight loss. There is no evidence that interventions delivered within primary care settings by generalist primary care teams trained in weight management achieve meaningful weight loss.

Can professional soccer clubs help male fans lose weight and become more physically active? Preliminary evidence from the Scottish Premier League

Introduction: The prevalence of overweight/obesity amongst UK men is amongst the highest in Europe. Modest (5–10%) weight loss can reduce risk of co-morbidity, but many men are reluctant to engage in traditional commercial and health service weight management programmes. Football Fans in Training (FFIT) is a gender-sensitized, weight loss, physical activity (PA) and healthy living intervention that aims to engage men in sustained positive lifestyle change by using Scotland's elite professional football (soccer) clubs as a vehicle for delivery.

Behavioural and Motivational Factors Associated with Weight Loss and Maintenance in a Commercial Weight Management Programme

This survey examined self-reported behaviour changes associated with weight loss and maintenance in a group of 292 members of a commercial weight management organisation (CWMO). Mean (SD) joining weight was 89.0 (20.0) kg, duration of membership was 29.1 (16.2) months and time taken to reach their current weight was 16.3 (13.5) months. Mean (SD) weight change was -15.6 (11.4) kg and BMI change was -5.7 (4.0) kg/m 2 , (both p<0.001), which had been maintained for 11.7 (12.8) months. Primary factors reported by participants as important in achieving their weight loss included not going hungry by satisfying appetite with low energy density food eaten ad libitum, following a flexible diet, peer-group support and tools to cope with small lapses. Several reported eating/activity behaviours significantly correlated with weight loss maintenance (WLM). However in regression analysis, while most individual changes in eating behaviour and activity behaviour were significant predictors of weight change in this group, no variables explained more than a few percent of the variance, after adjusting for age, gender, height and starting weight. A range of eating and activity behaviours was associated with weight loss maintenance. It is important to offer consumers flexible solutions they can adapt to their individual lifestyle needs.

Attendance and weight outcomes in 4754 adults referred over 6 months to a primary care/commercial weight management partnership scheme.

• There is growing evidence of the effectiveness of commercial weight management programmes in the community. A recent randomized controlled trial has shown commercial providers to be more effective than NHS providers for weight management solutions in primary care. Some commercial weight management providers have established national slimming on referral schemes for weight management, which result on average in weight losses of 4-5% over a 12-week referral period. A recent randomized controlled trial of a similar scheme over 12 months yielded similar weight loses. Another RCT comparing commercial providers over 6 months showed average weight losses of ∼6.6% across providers. • The present study shows that when local primary care practitioners target resources to where they, as health professionals, felt they would have the most beneficial effect in their local communities, greater weight losses can be achieved. • Different NHS Trusts extended 12-week referrals by an additional 12 weeks in a total of 4754 patients. • Mean weight losses of 8.6% were achieved suggesting that local targeting of primary care resources can maximize returns for NHS investments in commissioning the services of commercial weight management organizations. This project audited attendance and weight loss in a primary care/commercial weight management partnership scheme in patients who participated over 6 months. 4754 adult patients (575 men, 4179 women) were referred to Slimming World for 24 weekly sessions. Data were analysed using individual weekly weight records. Mean (standard deviation, SD) body mass index (BMI) change was -3.3 kg m(-2) (2.2), weight change -8.9 kg (6.0), percent weight change -8.6% (5.3) and number of sessions attended 21.3 (3.2) of 24. For patients attending at least 20 of 24 sessions (n = 3626 or 76.3%), mean (SD) BMI change was -3.6 kg m(-2) (2.2), weight change -9.6 kg (6.1), percent weight change -9.3% (5.3). Weight loss was greater in men than women (P < 0.001). 74.5% of all patients enrolled, and 79.3% of patients attending 20 or more sessions achieved at least 5% weight loss. 37.3% of the whole population lost ≥10% of their weight. Weight gain was prevented in 96.3% of all patients referred. Referral to a commercial organization for community-based lifestyle intervention is a practical option for longer-term National Health Service weight management strategies.

Provision of commercial weight management programmes

Provision of commercial weight management programmes

Women's experience of commercial weight−loss programmes

Aim: To explore how female participants viewed commercial weight-management programmes (CWMPs) and how the programmes compare to NICE guidelines. Method: The sample comprised 12 female volunteers who were university employees and had attended a CWMP in the last 5 years. Semi-structured qualitative interviews were conducted. Results: The calculation of target weights and rate of weight loss encouraged varied between programmes. Participants reported choosing lower calorie options and reducing portion sizes while adhering to the CWMP diet. There was some evidence that participants ate large quantities of 'unlimited' foods. Participants were uncomfortable with the promotion of branded products at CWMP meetings. All participants valued the weigh-in and felt accountable to the individual weighing them. The meetings included behaviour-change techniques, including group discussions, but the majority of participants elected to avoid these elements. Conclusions: This study provides evidence that CWMPs vary in their accordance with national guidelines. The extent to which CWMPs enable adults to manage their weight in the long term warrants further study.

Influence of Slimming World’s lifestyle programme on diet, activity behaviour and health of participants and their families

Understanding the impact of commercial weight management programmes on behaviour change is an area that requires greater evidence. The present study investigated the impact of a commercial weight management organisation's diet and activity programmes on the lifestyles of those accessing the services and their families. This survey was based on self-reports from a group of people involved in their own weight control. A questionnaire consisting of multiple choice and open-ended questions regarding diet, activity patterns and health was distributed in a commercial slimming organisation's magazine and was available on the website for a 4 week period. Two thousand eight hundred and twelve respondents were analysed, including the organisation's members (53%) and nonmembers (47%). Those following the dietary programme reported significant changes towards healthier food choices in line with current guidelines (P < 0.01). Over 80% reported an improvement in their own health and over 26% reported an improvement in their partner's or family's health (P < 0.01). Respondents reported increasing physical activity after being made aware of the organisation's activity programme (P < 0.001). Members were more likely to have become more active than nonmembers (P = 0.011). The longer respondents had been members, the more likely they were to report an increased participation in physical activity (P = 0.02). Half of those reporting increased activity indicated that their partner or whole family had also increased their activity levels. The commercial slimming organisation's programme appeared to be having a beneficial impact on the diet and activity behaviours of those accessing the service. Group members were more likely to make positive behaviour changes and health improvements tended to increase with the duration of membership. The improvements observed with respect to both diet and activity levels also reached the wider family network.