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BackgroundSpecialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented.Subjects/methodsThe study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35 kg/m2 with comorbidity or ≥40 kg/m2 without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data.ResultsOf the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m2) with 87.2% of patients having a BMI≥40 kg/m2 and 12.4% with BMI≥60 kg/m2. The mean weight change of all patients enrolled was −4.1 kg (95% CI −3.6 to −4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving −5.5 kg (95% CI −4.2 to −6.2 kg, p=0.0001) and non-completers achieving −2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss.ConclusionsThe SLiM programme is an effective group intervention for the management of severe and complex obesity.

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A number of serious studies have been conducted to decipher relationships between geological environment, potable/ drinking water, and diseases as they were considered to have triggered suffering due to diseases among people. Chronic anemia can be caused by prolonged exposure to drinking water contaminated with cadmium (Cd). Under such circumstances, accumulation of Cd is manifested in the kidney, resulting in cancer and cardiovascular diseases. The aim of this study is to present the impact of Cd-contaminated drinking water on human health among the residents of villages in Winder. Collection of about 48 groundwater samples at an average distance of 1 to 2 km between the sampling sites has enabled a sufficient geological representation of distribution of minerals and elements in the samples. Concentration and comparison of Cd in the study area sample sites reveal highest values (24.2-30.0 ppb) in the northeastern and southeastern sectors, covering parts of all three geological areas of Bela Ophiolite of Cretaceous age. Conducted questionnaire surveys provided relevance between cause and effect nature of Cd bearing diseases among which kidney, joint, and night blindness are more prominent. Due to this phenomena, toxic risk of Cd in drinking water was high as per calculated health hazard indices. The use of this water by the villagers may cause health problems and disorders among the inhabitants of the area.