A real-life structured weight management intervention in patients with diabetes can reduce weight in the medium term, result in improved glycaemic control with fewer medications, and may be more effective than pharmacological alternatives. Challenges include getting a higher proportion of patients referred to and engaged with interventions.

Aim To compare weight change in a lifestyle-based weight management programme between participants taking weight-gaining, weight-neutral/loss and mixed diabetes medications.Methods Electronic health records for individuals (≥ 18 years) with Type 2 diabetes who had been referred to a nonsurgical weight management programme between February 2008 and May 2014 were studied. Diabetes medications were classified into three categories based on their effect on body weight. In this intervention cohort study, weight change was calculated for participants attending two or more sessions.Results All 998 individuals who took oral diabetes medications and attended two or more sessions of weight management were included. Some 59.5% of participants were women, and participants had a mean BMI of 41.1 kg/m 2 (women) and 40.2 kg/m 2 (men). Of the diabetes medication combinations prescribed, 46.0% were weight-neutral/loss, 41.3% mixed and 12.7% weight-gaining. The mean weight change for participants on weight-gaining and weightneutral/loss diabetes medications respectively was À2.5 kg [95% confidence interval (CI) À3.2 to À1.8) and À3.3 kg (95% CI À3.8 to À2.9) (P = 0.05) for those attending two or more sessions (n = 998). Compared with those prescribed weight-neutral medications, participants prescribed weight-gaining medication lost 0.86 kg less (95% CI 0.02 to 1.7; P = 0.045) in a model adjusted for age, sex, BMI and socio-economic status.Conclusions Participants on weight-neutral/loss diabetes medications had a greater absolute weight loss within a weight management intervention compared with those on weight-gaining medications. Diabetes medications should be reviewed ahead of planned weight-loss interventions to help ensure maximal effectiveness of the intervention.

This paper reports data from a survey of a random sample of the British general public in one large city, drawn from the electoral roll. Subjects were invited to have a fitness check and to participate in an exercise programme. Age, gender and employment status were found to be related to willingness to volunteer for a fitness check and motivation to participate in an exercise programme. The implications of this for population based approaches to positive health behaviour are discussed. INTRODUCTIONTarget 16 of WHO's Health for All strategy states that there should be significant increases in positive health behaviour by the end of the twentieth century (WH0,1985). Included in the WHO definition of positive health behaviour is physical activity. The extent to which members of the general public can be encouraged to participate in physical activity using simple postal invitation technique, is the subject matter of this paper.A random sample of the general public in one large city was invited to attend a local sports centre for a fitness check and offered the opportunity to take part in a structured programme of physical exercise free of charge, taught by university staff. The location of the fitness check and the exercise classes was a major indoor international sports facility close to the univeristy where the research was conducted. The sports facility, where the university leases a certain amount of time for teaching and research purposes, is owned and administered by the local district council. The sports centre and university are located centrally within a major industrial and commercial city in the United Kingdom.