Summary
Multi‐disciplinary specialist services have a crucial role in the management of patients with obesity. As demand for these services increases, so too does the need to monitor individual service performance and compare outcomes across multiple sites. This paper reports on results from the publicly funded Canberra Obesity Management Service. A descriptive observational study was conducted on new patients who attended an initial medical review from July 2016 to June 2017. Baseline characteristics, comorbidities, attendance, service utilization and outcomes were collated until June 2018. Of the 162 patients identified, 64% continued to attend beyond initial medical review. Dietetics was the most commonly accessed allied health service, followed by exercise physiology and psychology. Very low‐energy diet was the most commonly trialled intensive intervention, followed by pharmacotherapy and bariatric surgery. Mean baseline weight for those who continued beyond initial medical review was 142.0 kg (SD 26.6 kg), with a mean weight change of −6.2 kg (SD 10.2 kg) and a mean change in percentage body weight of −5% (SD 7%). Clinically significant weight loss was achieved in 36% of these patients, with a further 47% achieving weight stabilization. Mean Depression, Anxiety and Stress Scale scores reduced from 8‐6‐8 to 7‐5‐5, and mean Epworth Sleepiness Scale scores decreased from 8/24 to 6/24. Polysomnography referrals were made for 37% of all new patients, 87% of whom were diagnosed with varying degrees of obstructive sleep apnoea. We present these findings in the hope that they may serve as an example for data collection, individual service monitoring and comparison across multiple obesity services.
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Objective: Obesity is associated with co-morbid mental illness. The Canberra Obesity Management Service (OMS) supports adults with severe obesity who have the psychosocial capacity to engage. This study will determine whether mental illness is a predictor of OMS attendance and anthropometric changes. Method: A retrospective audit was performed from July 2016 to June 2017. Baseline characteristics, attendance and anthropometrics were stratified according to the presence of mental illness. Outcomes included weight stabilisation and clinically significant weight loss. Descriptive analyses were performed. Results: Mental illness was present in 60/162 patients (37%). Attendance was similar for those with and without mental illness. Patients with mental illness had twice as many co-morbidities ( p = .001). Depressive disorders were most common ( n = 28, 47%). Anxiety, schizophrenia spectrum and other psychotic disorders, and trauma- and stressor-related disorders also featured. Weight stabilisation was achieved by 25 patients (66%) with mental illness and 25 (35%) without. Clinically significant weight loss was observed in 10 patients (26%) with and 26 (40%) without mental illness. Conclusion: The presence of mental illness did not impact OMS attendance or weight stabilisation. The higher rate of co-morbidities in those with mental illness highlights the challenges faced by this vulnerable population.
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