Slim Group Research Articles

Three and Twelve Month Body Mass Outcomes After Attendance at a Community-Based Weight Management Intervention in the North West of England

Background: Research suggests that commercial weight management services are efficacious in helping people manage their body mass, but they typically only include education and advice on physical activity. The objective of this analysis was to assess 3- and 12-month body mass after attendance at a community-based weight management programme delivered by a commercial slimming group, which included the provision of tailored physical activity sessions by a local leisure trust between January 2009 and November 2014. Methods: After institutional ethical approval and participants giving informed consent, a retrospective analysis of a 12-week multi-component intervention, tier 2 community weight management service for adults in Wigan, North West England, United Kingdom, was undertaken. Participants’ (n = 8514) mean ± SD age was 47.4 ± 14.3 years and starting body mass was 86.7 ± 14.3 kg. The main outcome measure was body mass (kg) at 0 months (baseline), 3 months (immediately post intervention) and 12 months. Significant differences in body mass were ascertained if p < 0.05 using repeated measures ANOVA with Bonferroni post hoc test, with effect sizes calculated using partial eta squared. To confirm and account for missing data, the Last Observation Carried Forward (LOCF) approach was used. Results: Repeated measures ANOVA showed a significant effect of time (p < 0.01, ηp2 = 0.36). Post hoc tests revealed there was a significant reduction in body mass from baseline to 3 months (86.7 ± 14.3 kg vs. 81.2 ± 13.6 kg) and baseline to 12 months (79.7 ± 14.0 kg). The difference between 3 months and 12 months was also significant. LOCF confirmed a significant effect of time (p < 0.01, ηp2 = 0.42), with all previously highlighted significant differences remaining. Conclusions: Significant reductions in body mass were reported at 3 and 12 months, providing evidence for the efficacy of the community weight management programme that included tailored physical activity opportunities for participants. Whilst comparisons to a resting control group cannot be made, partnerships between commercial slimming groups and local leisure providers should be encouraged and explored nationally.

Effects of AIDiet intervention to improve diet quality, immuno-metabolic health in normal and overweight PCOS girls: a pilot study

This study was conducted in two groups of girls with PCOS (polycystic ovary syndrome) categorized as slim (group N) and overweight-to-obese (group Ov/Ob). The study's primary outcome was to assess the impact of a 12-week anti-inflammatory diet (AIDiet) intervention, without energy deficit, on daily diet quality improvement, evaluated according to the KIDMED index. The secondary outcome was improving inflammatory, redox, hormonal, and metabolic statuses. In the study, which was completed by 13 girls from the Ov/Ob group and 19 girls from the N group, a significant improvement in the mean KIDMED score was obtained. Moreover, the intervention significantly improves concentration of total antioxidant capacity (TAC), fasting insulin, and the homeostatic model assessment for insulin resistance (HOMA-IR) index, in the Ov/Ob group, while both groups experienced a reduction in the concentration of interleukin (IL)-1 and IL-6, tumour necrosis factor (TNF-α), and androstenedione. The AIDiet intervention effectively improved the quality of the subjects' diets, which was associated with the improvement of hormonal and immuno-metabolic markers. However, these changes in normal-weight patients were observed regardless of body weight reduction. ClinicalTrials.gov Identifier NCT04738409.

The reality of living with obesity.

I grew up on a little Island in the English Channel, nestled between the south coast of England and France, called Jersey. It was a wonderful place to grow up and I had a fabulous childhood. I went through puberty early as a child, which made me feel different to the other children, and I didn't like it. I went to an all-girls’ secondary school, which amplified how different in terms of development my body was compared with the other girls. This is when I started fixating on my weight. I remember attending a slimming group with my mum in my early teens, and I had tried my first very low-calorie diet by the age of 16 years.

The Impact of Body Mass Index Values on the Quality of Cardiopulmonary Resuscitation: a Manikin Study

Objective: The purpose of this study is to assess the impact of body mass index (BMI) on the quality of cardiopulmonary resuscitation (CPR) by using a manikin. Methods: 50 people composed of research assistants, intern doctors, emergency medical technicians and nurses who had previous cardiopulmonary resuscitation experience performed CPR on Laerdal Skillmeter Resusci-Anne® with SimPad manikin during the study. BMI data of participants were recorded and then the participanst were categorised as BMI <21 and BMI >21. Compression data obtained from the summary section of SimPAD QCPR were compared with the participants BMI values. Results: 18 (36%) out of 50 participants were male, while 32 (64%) were female. 16 (32%) out of 50 participants were in the slim group, while 34 (68%) were in the normal group. Mean age of participants was calculated as 26.8±4.2, and mean BMI as 22.56±3.32. Mean compression depth in the slim group was significantly lower in comparison to the normal group (slim51.94±4.64, normal 55.79±4.35, p=0.006). Compression ratiowith sufficient depth in the slim group was statistically lower than the normal group (slim 66.19±25.79, normal 87.29±19.36, p=0.002). A statistically significant positive correlation was found in the lineer regression analysis conducted between mean compression depth and BMI (r2:0.179, p=0.002). Moreover, a significant positive correlation was observed in the pearson correlation analysis of mean compression depth and BMI (r: 0.423, p= 0.002). Conclusion: As a result, it was found out that low BMI values are associated with low mean compression depth.

Initial experience with a novel, modular, minimalistic approach for transfemoral aortic valve implantation

ObjectivesWe introduce a novel approach that involves a single arterial access and low contrast agent volume (SLIM). BackgroundTranscatheter aortic valve implantation (TAVI) is subject to an ongoing process of refinement and simplification. MethodsBetween January 2019 and November 2020, a total 888 patients with severe aortic stenosis underwent transfemoral TAVI using balloon-expandable or specific self-expanding devices. The study cohort comprised patients with attempted SLIM approach (n = 291). A matched cohort of patients who were treated in a standard fashion served as control group (n = 291). ResultsThe SLIM approach was successful in 92.4% of attempted cases. In the SLIM group, utilization of contrast agent (23 [19–37] vs. 75 [52–100] ml; p < 0.001), rates of any acute kidney injury (5.5% vs. 12.7%; p = 0.002), complications at the secondary access (0.3% vs. 3.1%; p = 0.011) and length of hospital stay (7 [5–8] vs. 7 [6–9]) days; p = 0.039) were significantly reduced. All other procedural outcomes were similar between groups. ConclusionsInitial results of this novel, minimalistic approach demonstrate its feasibility and potential beneficial effects without compromising procedural safety. Further refinement of this approach is warranted.

New Species of Gyrodactylus von Nordmann, 1832 from Native Fish from Chiapas, Mexico, Studied by Morphology and Molecular Analyses.

Three new species of Gyrodactylus von Nordmann, 1832 are described from Poeciliopsis hnilickai and Tlaloc labialis (syn. Profundulus candalarius and Profundulus labialis) from the state of Chiapas, Mexico. Gyrodactylus chiapaneco n. sp. is described from T. labialis. Gyrodactylus guatopotei n. sp. was found to infect P. hnilickai. Gyrodactylus tlaloci n. sp. is described from T. labialis. The new species were characterised morphologically (haptoral hooks) and molecularly (sequences of the Internal Transcribed Spacer region (ITS1-5.8S-ITS2) of rDNA). During a survey in March 2017 in the state of Chiapas, individuals of Tlaloc labialis were collected by electrofishing from Arroyo Ojo de Agua and from Río Hondo, Ixtapa, Río Las Lajas and Poeciliopsis hnilickai from Río Hondo, Ixtapa and Río Cacao. Three new species of Gyrodactylus were found and are described herein based on morphological and genetic analysis. Attachment hooks were excised and partially digested with a proteolytic solution to remove tissue enclosing the haptoral armature. Measurements and pictures of the haptoral hard structures were taken and were compared with other Gyrodactylus species found on poeciliids and profundulids. The bodies from which haptoral hook were removed were stored individually in 95% ethanol at -20 °C for molecular analyses. Sequences of the Internal Transcribed Spacer region of rDNA were obtained for each species and were compared with 26 Gyrodactylus spp. The genetic divergence among species of Gyrodactylus was estimated using uncorrected "p" distances with the program MEGA. The haptoral hook of Gyrodactylus chiapaneco n. sp. are similar to G. poeciliae from Venezuela; those from Gyrodactylus guatopotei n. sp. resemble the sclerites of G. turnbulli from Singapore and G. pictae from Trinidad, and the haptoral hooks of Gyrodactylus tlaloci n. sp. are comparable to those of G. pseudobullatarudis and G. zapoteco from Mexico; most of these parasites were described from poeciliid fishes, except G. zapoteco which was recently described from Profundulus oxacae from Oxaca, Mexico. The sequences of the three new species were aligned with sequences of 26 other Gyrodactylus spp. Maximum likelihood and Bayesian inference analyses indicated that the three new taxa are members with well-supported lineages-the new taxa are the first species of Gyrodactylus to be described from Poeciliopsis hnilickai and Tlaloc labialis from Chiapas. Gyrodactylus chiapaneco n. sp., Gyrodactylus guatopotei n. sp. and Gyrodactylus tlaloci n. sp. are described based on morphological and molecular analyses. Two of the three new species of Gyrodactylus described here, and both roughly fall morphologically and molecularly into the group of parasites harbouring slender marginal hooks: G. chiapaneco n. sp. and G. tlaloci n. sp. both possess marginal sclerites with slim shafts and group phylogenetically with other gyrodactylids of similar marginal hook morphology. Gyrodactylus guatopotei n. sp. groups with gyrodactylids possessing marginal hooks with quite elongated shafts, most of which have been found infecting poeciliids in the Antilles (e.g. G. pictae and G. turnbulli). Poeciliid, profundulid and goodeid fishes are morphologically and ecologically similar and nowadays live in sympatry or close geographical distance in Mesoamerica.

Slim Body Weight Is Highly Associated With Enhanced Lipoprotein Functionality, Higher HDL-C, and Large HDL Particle Size in Young Women.

There has been no information about the correlations between body weight distribution and lipoprotein metabolism in terms of high-density lipoproteins-cholesterol (HDL-C) and cholesteryl ester transfer protein (CETP). In this study, we analyzed the quantity and quality of HDL correlations in young women (21.5 ± 1.2-years-old) with a slim (n = 21, 46.2 ± 3.8 kg) or plump (n = 30, 54.6 ± 4.4 kg) body weight. Body weight was inversely correlated with the percentage of HDL-C in total cholesterol (TC). The plump group showed 40% higher body fat (26 ± 3 %) and 86% more visceral fat mass (VFM, 1.3 ± 0.3 kg) than the slim group, which showed 18 ± 2% body fat and 0.7 ± 0.2 kg of VFM. Additionally, the plump group showed 20% higher TC, 58% higher triglyceride (TG), and 12% lower HDL-C levels in serum. The slim group showed 34% higher apoA-I but 15% lower CETP content in serum compared to the plump group. The slim group showed a 13% increase in particle size and 1.9-fold increase in particle number with enhanced cholesterol efflux activity. Although the plump group was within a normal body mass index (BMI) range, its lipid profile and lipoprotein properties were distinctly different from those of the slim group in terms of CETP mass and activity, HDL functionality, and HDL particle size.

Is the Ambu aScope 3 Slim single-use fiberscope equally efficient compared with a conventional bronchoscope for management of the difficult airway?

Study ObjectiveThe study objective was to evaluate whether the single-use fiberoptic bronchoscope (FOB), Ambu aScope 3 Slim, was equally efficient compared with the conventional reusable FOB, Olympus LF-GP, for nasal fiberoptic intubation in a manikin. DesignA randomized crossed-over study. SettingThe postanesthesia care unit of Tokyo Women's Medical University Hospital. SubjectsTwenty anesthesiologists who have experienced >50 one-lung ventilation thoracic surgery procedures were invited to participate in this study. InterventionsA 6.5-mm internal diameter cuffed endotracheal tube (ET) was inserted into the manikin under Ambu aScope 3 Slim (group A) or Olympus LF-GP (group C) guidance. MeasurementsThe following time parameters from the beginning of FOB insertion through a nostril were compared between groups: until vocal cord visualization (T1); visualization of the carina (T2); and proper ET placement, as confirmed by the distance of the ET tip to carina (T3). Main ResultsMean (SD) T1 in group A and group C were 20 seconds (17 seconds) and 14 seconds (12 seconds), respectively (P= .1050). Mean (SD) T2 in group A and group C were 40 seconds (29 seconds) and 25 seconds (15 seconds), respectively (P= .0287). Mean (SD) T3 in group A and group C were 70 seconds (33 seconds) and 50 seconds (22 seconds), respectively (P= .0098). One case in group A had failed intubation ConclusionsThe Ambu aScope 3 Slim required more time to intubate than the conventional reusable FOB. It requires more rigidity, similar to the conventional FOB for management of the difficult airway.

THU0121 Comparison of MTX Therapy with or without A Moderate Dose Glucocorticoid Bridging Scheme in Early Rheumatoid Arthritis Patients Lacking Classical Poor Prognostic Markers: Week 16 Results from the Randomized Multicenter Carera Trial

BackgroundWhereas early intensive treatment to target is recommended in severe early Rheumatoid Arthritis (eRA), few data are available in patients presenting without bad prognostic markers.ObjectivesTo evaluate the efficacy and safety...

Sin or Slim?

Is fat a sin? Popular ‘knowledge’ about obesity which frames fat as an avoidable behavioural condition would certainly suggest it can be blamed on the fat person. Discourses of health reproduced within public policy and media reporting assist in the pathologization of fat bodies, insisting that fat is the result of unhealthy lifestyle choices. It is, however, not simply medical interpretations of fat that facilitate this moral discourse. Religion also provides an important source of moral judgment. This paper draws on my qualitative research inside a UK secular, commercial slimming group to consider how the Christian moral language of sin functions within this setting to construct a politics of choice that holds the dieter personally responsible for her fat. Interpreting weight loss and weight gain as a measure of moral character, this theological language assists in the operation of ‘normative conformity’, conforming women’s bodies to cultural knowledge about fat.

幼児期の体格変化と生活時間および体力変化の 多角的関係性の検討

[Purpose] The purpose of this study was to examine the multiple relationships between body proportion,physical fitness, and daily life time of young children, using three years of longitudinal data. [Method] The study subjects comprised 148 young children from whom longitudinal data were collected for three years.We collected data on body proportions, physical fitness, and daily life time. [Results and Discussion] The results confirmed that the change in physical fitness score was the highest in the obesity trend group, followed by the maintaining body proportion group, and that this change was the least in the slim trend group. Regarding the daily life time, significant difference was observed in the change of the obesity index by the time spent on TV and video systems. Further, the time spent by the children playing on a PC and video games was marginally significant. It was also confirmed that the time spent on TV and video systems was shorter among children in the slim trend group. Our findings suggest that the improvement of daily life time, desirable change in body proportions, and improvement in physical fitness might be affected by multiple activities related to the mutual factor.

3D 인체 스캔 데이터를 활용한 체형별 인대모형 개발에 관한 연구

다양한 체형을 지니고 있는 소비자들에게 만족스러운 착용감을 주는 기성복 생산을 위해서는 체형 특성이 반영된 원형 제작이 필요하다. 인체는 체형에 따라 곡면의 형태가 달라지므로, 인체의 곡면 형태를 세분화하여 그 특성을 원형 설계에 반영할 필요가 있다. 그러나 기성복에서는 개인의 체형별 특징을 일일이 반영하기 힘드므로, 기성복 원형 제작에 활용 가능한 체형별 인대 모형이 요구되고 있다. 따라서 본 연구에서는 삼차원 인체스캔 데이터를 활용하여 체형을 분석하고 각 체형에 따른 인대모형 개발 방법을 제시하였다. 30대 성인 여성의 상반신 삼차원 인체 형상 자료를 분석한 결과, 체형 특성은 보통체형, 비만체형, 마른체형으로 분류되었다. 상반신을 기준선을 두어 나누어 계측한 결과, 체형에 따라 유의적인 차이가 나타났다. 계측된 각 부위별 삼차원 인체 치수를 기본 원형 설계 시 허리다트 위치 및 분량 설정에 반영하여 체형별 상반신 기본 원형을 제작하였으며, 이를 바탕으로 입체모형을 제작하여 스캔, 모델링 작업을 거쳐 체형에 맞는 원형 인대 모형을 제시하였다. 인대 모형은 인체의 입체 형상을 만들기 위한 다트선을 포함하고 있어 기본 원형 제작 및 원형 활용에 도움이 될 것으로 사료된다. This research proposes a pattern making method for women's bodice by the characters of body types and develops bodice dress forms on their body shapes applying 3D body scan data. 515 women's body scan data was collected and analyzed factor and cluster analysis. Three body types were characterized in normal, obese, and slim group. In each group, 10 subjects were selected. 20 parts in 3D anthropometric data were measured using Autocad program. The amount of waist dart was calculated and three types of basic bodice pattern were developed using the calculated darts data. The amount and the position of front dart and side dart were different at obese group in comparison of normal and thin group. The three types of basic bodice model were made by the basic bodice pattern, and each model was scanned by 3D scanner to make 3D bodice dress forms. Three types of bodice dress forms were rendered using 3D max program. Bodice dress forms had the dart lines and were useful to draft patterns to fit their body shape.

Information to fight the flab:

The purpose of the paper is to examine information use and information literacy in the context of weight management. It reports on a two-year study funded by the Department of Health known informally as the Net.Weight Study. Net.Weight examined the potential for increased, innovative and effective uses of information and communication technologies (ICTs) to support the self management of weight. The research was conducted in the city of Brighton &amp; Hove by an inter-disciplinary team from the University of Brighton. The paper gives a brief overview of the various methods used in the study as a whole but discusses one strand, the user survey, in more detail. The survey gathered data on people’s information and ICT use around weight management. The design of the survey questionnaire required the adaptation of existing literacy assessment instruments and this process is described in this paper. The findings show that people use a wide range of information sources for information and support around weight management. The most useful sources are slimming groups, food packaging, friends and family, magazines, TV and health books, thus representing a variety of media, formal and informal, and including human sources. The internet was reported to be a useful source for around half the survey respondents and is most often used for information about diet and exercise. A majority of respondents described themselves as active information seekers and confident about their information skills. They are less confident about internet information than information generally and even less confident about using the internet to support weight management activities. The concept of literacies, particularly around information and health, provide a framework for examining the Net.Weight findings. The findings are discussed in terms of their implications for health information policy and for those interested in applying information literacy theory to health. The role of healthcare practitioners in weight management information is addressed, as is the need for targeted rather than generic health information. It is suggested that the work done in the education sector to increase awareness of information literacy and improve skills could provide a useful model of good practice in a health context. However, the evidence provided by the Net.Weight study suggests that for such an approach to be relevant it needs to reflect the complexity of health information processes in everyday lives.

Constructions of ageing and narrative resistance in a commercial slimming group

This study focuses on the role of organisational setting and age in shaping individuals' narratives of embodied selfhood. It compares older and younger women's use of ‘narrative resistance’ to negotiate identity in light of their ageing and the negative social and personal meanings of being fat. Cordell and Ronai (1999) observed three types of narrative resistance among overweight people: loopholes, exemplars and continuums. This paper identifies two others: ‘justifications’, for behaviour that associated with weight gain, and ‘repentance’, for behaviour that reaffirmed a commitment to losing weight. Drawing from six months of participant-observation and in-depth interviews with 20 older and younger female clients of a commercial weight-loss organisation, this article shows that both the meanings women attributed to their experiences of slimming, and their opportunities for benefiting from organisational resources, varied by their stage in the lifecourse. The weight-loss group generated narrative strategies and opportunities for its members that were informed by both cultural constructions of ageing and the organisation's interests. While these strategies stopped short of empowering the clients to abandon restrictive dieting altogether, they did enable the older respondents to excuse temporary setbacks in weight loss and their deviation from (what they described as) the more exacting appearance standards of youth. At the same time, the strategic narratives reaffirmed constructions of ageing that present the older female body as uncontrollable and older women as unconcerned with physical attractiveness.

중년 여성의 체형에 따른 의복 태도

Middle age is the time of the most important meaning in life and also the time of physical and mental change, which offers new social activities for self-development. Middle-aged women form the major consumer class in current clothing industry, but few have been performed on this so far. The researcher studied in many aspect on the clothes which middle-aged women need to wear during this period of change. Thus this study is executed to examine what benefits middle-aged women pursue in clothing attitudes and the relationship among clothing pursuit benefit and their somatotype compensation and image orientation. The research performed the theoretical study and practical study simultaneously. The subjects are 238 middle-aged women between 35 and 49 years old in September, 2004. The results of this study are as follows: 1. The attitude of women's clothing patterns in relation with image consist of two factor structures. One is the body image and the other is the appearance image. 2. As a result of researching the attitude for choosing clothes of each body group by Rohrer index, the women with gross body group take a top priority for the lower-body compensation, while the women with slim body group take a top priority for volume compensation. 3. As a result of researching the cognitive somatotype group's attitude for choosing clothes, gross body group takes a top priority for lower-body compensation and upper-body compensation. 4. As a result of researching the relationship between real somatotype and cognitive somatotype by Rohrer index, middle-aged women think of themselves as being fatter than present state. And choosing the clothes, the body misunderstanding group of women usually show that they consider more compensation than the normally body understanding group. 5. The evaluation on real somatotype, cognitive somatotype, ideal somatotype influences on the body cathexis.

Single and Double pH‐Driven Cu2+ Translocation with Molecular Rearrangement in Alkyne‐Functionalized Polyamino Polyamido Ligands

A new series of ligands, containing one (L1H(2)-L4H(2)) or two (L5H(4)-L6H(4)) 1,4,8,11-tetraaza-5,7-dione units and functionalized with a propargyl group on the C atom between the C=O moieties, has been synthesized. Protonation constants for the ligands and formation constants of their Cu(2+) complexes have been determined in water, and the coordination geometry of the complexes existing at various pH values has been investigated by coupled pH-metric and spectrophotometric titrations. Ligands capable of simple uptake of Cu(2+) with the formation of neutral, square-planar complexes containing the -2-charged diamino-diimido donor sets and ligands containing further coordinating groups (quinoline or pyridine) capable of single and double cation translocation have been investigated. The role of the substituents on the amino groups and the structural role played by the propargyl group have been examined as regards Cu(2+) complexation and translocation. In the double-translocating ligand L6H(4), when the two Cu(2+) ions move inside the diamino-diamido donor set, the slim propargyl group allows an unprecedented folding of the whole ligand with apical coordination of one pyridine to form a five-coordinate, square-pyramidal Cu(2+) ion. The crystal and molecular structures of this unusual [L6Cu(2)] complex have been determined by X-ray diffraction. Finally, oxidation of Cu(2+) to Cu(3+) has been studied by cyclic voltammetry in water, which revealed that the redox reaction occurs only when the copper cation is within the diamino-diimido compartment. Moreover, both functionalization of the primary amines with bulky substituents and apical coordination of Cu(2+) make access to the 3+ oxidation state more difficult and disrupt the reversibility of the electrochemical process.

Tackling obesity in men – preliminary evaluation of men‐only groups within a commercial slimming organization

Over Slimming World's 36-year history men have always made up a small percentage of the slimming organization's membership. Past company research suggested that men would feel more comfortable in men-only groups rather than mixed. In 2002, Slimming World set a target to raise the awareness among men about the dangers of being overweight and made practical weight-management solutions more accessible through a national network of men's groups. To evaluate men's weight loss within these 'men-only' groups. Data analysed included those men having attended a group for at least 8 weeks. At the point of data collection average BMI had decreased from 35.9 to 32.5 kg m(-2). At least 5% weight loss was achieved in 90% of the sample. In those who had been members for 24 weeks 69% achieved a 10% weight loss. Shift working did not affect weight loss success. This data shows that overweight and obese men attending Slimming World are successful at losing weight in this environment and can achieve recommended health-related weight loss targets. There should be a move to get away from the mis-perception that slimming groups are only for women and raise awareness of the commercial option to men.

Weight management in primary care: how can it be made more effective?

Obesity is often difficult to tackle in primary care. Pressure of time in the consultation, a lack of appropriately-trained primary care staff, a shortage of community dietitians or nutritionists, the potentially enormous caseload, language or cultural barriers and the sheer intractability of patients' eating habits, exercise behaviour and their clinical condition, all conspire to make general practitioners, other team members and often the patients themselves lose heart and stop even trying. However, there are ways of overcoming these difficulties. Examples of changes that evidence suggests are able to support and enhance basic one-to-one interventions in general practice include: improved clinical guidelines; better training of primary care staff; at-risk patient registers; smarter database search tools; new quality incentives; closer working with dietitians, counsellors and pharmacists; more hospital outreach clinics; designated general practitioner specialists and practice clustering; expanded exercise referral schemes and links with leisure providers; subsidised referral to commercial slimming groups; better use of patient groups and voluntary and community workers. The present paper describes a proposed 'triple-tier' pathway for weight management incorporating most of the elements mentioned earlier. With a more joined-up and creative approach to the development and organisation of primary care, more comprehensive training and workforce planning, and better integration with social care, voluntary groups and the commercial sector, weight management in general practice has the potential to be much more effective.

Concentrations of calcium, copper, iron, magnesium, potassium, sodium and zinc in adult female hair with different body mass indexes in Taiwan

We investigated concentrations of calcium, copper, iron, magnesium, potassium, sodium and zinc using atomic absorption spectroscopy in the hair of four groups of adult females (n = 392), ranging in age from 20 to 50 years, with different body mass index (BMI): BMI < 18, slim group; BMI 18-25, normal group; BMI 26-35, overweight or obese group; and BMI>35, morbidly obese group. We found that the group with BMI < 18 had the highest ratios for [Ca]/[Mg], [Fe]/[Cu] and [Zn]/[Cu], but the lowest ratio for [K]/[Na] in hair. On the contrary, the group with BMI > 35 had the highest ratio for [K]/[Na], but the lowest for [Fe]/[Cu] and [Zn]/[Cu] in hair. Furthermore, when we compared concentrations of Ca, Cu, Fe, Mg, K, Na and Zn between the groups with BMI < 18 and BMI > 35, we found that there were significant differences (p < 0.05) in zinc concentrations between these two groups. In addition, there were significant differences in Ca, Cu, Mg, K and Na concentrations, with p < 0.01 at least. From this point of view, we suggest that hair concentrations of Ca, Cu, Fe, Mg, K, Na and Zn may be correlated with adult female BMI, but further studies are needed.

Tackling obesity in primary care: assessing the practicalities of working in partnership with the commercial slimming sector

Introduction: The prevention and management of overweight and obesity are fundamental to a number of national service frameworks. The strategic aims for managing obesity in southern Derbyshire include the proposal that obese individuals would be provided with one free opportunity to join a weight management programme run by a commercial slimming organization (Avery, 2000). The aims of the present study were to investigate whether people referred from primary care to a commercial slimming club went on to attend the club and to reduce their body weight. The study also aimed to examine experiences of participants and to consider the cost implications.Method: Between September 2001 and February 2002, two inner‐city practices recruited patients who fulfilled the following criteria: body mass index (BMI) &gt;30 kg m−2, aged 18–70 years, not pregnant and no attendance of a slimming group in the previous 3 months. Each patient was given vouchers covering free membership and 3‐month attendance at a local Slimming World class of their choice so that they could participate without being made to feel different from other class members. Patients were encouraged to stay in the programme after 3 months but they then became responsible for their own weekly fees. The primary care team reviewed each patient on referral, and 3 and 6 months later examining weight change and using a series of questionnaires designed to collect socio‐economic data and information relating to general health, lifestyle, motivation to lose weight and experience of the club. Data were analysed using SPSS.Results: A total 107 patients were recruited, 88% of whom were women. The mean age was 49.5 years and 11% were known to have diabetes. At the start of the study, the mean BMI was 36 kg m−2 (range, 30–47) with 50% having a BMI &gt;35 kg m−2. Following recruitment, 85% (n = 91) participants enrolled with a Slimming World class. Of the enrolled population, 68% (n = 62), completed the 3‐month free attendance at the class of their choice. Of the participants who completed, 76% (n = 47) indicated that they intended to carry on attending the class, but paying normal class fees. At 3 months, the mean weight loss of participants completing the free attendance was 5.4 kg (SD 3.5), while at 6 months, the mean weight loss was 11.0 kg (n = 34).The qualitative data support the partnership between the health sector and a commercial slimming organization, expressed by individual patients: ‘had I not had the push from the surgery I would not have gone despite being overweight’, ‘I was helped at a time when I had a low self‐esteem and financial problems’.Discussion: There is a need to be innovative in the management of obesity, with dietitians and nursing staff becoming increasingly in short supply. The commercial sector has an already established infrastructure and a ‘product’ that is well taken up by the general public. Collaboration betweem primary care trusts and commercial organizations has the potential to benefit both in an approach that could be cost‐effective and sustainable. The standard cost per patient for Slimming World membership and 3‐month attendance is £55 with bulk packages being available to primary care trusts at approximately £42.50 per patient. This compares favourably with other treatment options for obese patients including, for example, pharmacotherapy where the typical cost of 3‐month treatment with Orlistat is approximately £126.The work was supported by Southern Derbyshire Health Authority and Slimming World.