A pragmatic randomised controlled trial in primary care of the Camden Weight Loss (CAMWEL) programme

Abstract

ObjectivesTo evaluate effectiveness of a structured one-to-one behaviour change programme on weight loss in obese and overweight individuals.DesignRandomised controlled trial.Setting23 general practices in Camden, London.Participants381 adults with body mass index ≥25 kg/m2 randomly assigned to intervention (n=191) or control (n=190) group.InterventionsA structured one-to-one programme, delivered over 14 visits during 12 months by trained advisors in three primary care centres compared with usual care in general practice.Outcome measuresChanges in weight, per cent body fat, waist circumference, blood pressure and heart rate between baseline and 12 months.Results217/381 (57.0%) participants were assessed at 12 months: missing values were imputed. The difference in mean weight change between the intervention and control groups was not statistically significant (0.70 kg (0.67 to 2.17, p=0.35)), although a higher proportion of the intervention group (32.7%) than the control group (20.4%) lost 5% or more of their baseline weight (OR: 1.80 (1.02 to 3.18, p=0.04)). The intervention group achieved a lower mean heart rate (mean difference 3.68 beats per minute (0.31 to 7.04, p=0.03)) than the control group. Participants in the intervention group reported higher satisfaction and more positive experiences of their care compared with the control group.ConclusionsAlthough there is no significant difference in mean weight loss between the intervention and control groups, trained non-specialist advisors can deliver a structured programme and achieve clinically beneficial weight loss in some patients in primary care. The intervention group also reported a higher level of satisfaction with the support received. Primary care interventions are unlikely to be sufficient to tackle the obesity epidemic and effective population-wide measures are also necessary.Clinical trial registration numberTrial registrationClincaltrials.gov NCT00891943.

Technology-Assisted Weight Loss Interventions in Primary Care: A Systematic Review

“…70 Several studies used "other" personnel (5/16, 31 %). 58,60,63,68,70 These ranged from "fitness instructors," 63 to "weight loss coaches," 58 to "community health educators." 60 These personnel had varied levels of training and were most often involved in lifestyle coaching delivered via various modalities, including in-person, telephone, and email-based exchanges similar to the RD studies.…”

“…We therefore aggregated our results with ranges and narrative summation in most instances. [58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73] met inclusion criteria and are summarized in Table 1. For readers interested in additional tabular detail and narrative summation of each trial, see Supplemental Table 2 Personnel Figure 2 illustrates the association between weight loss and mix of personnel delivering the intervention.…”

Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis

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“…Andrews et al 22 (1) Andrews et al 22 (2) Appel et al 19 Balducci et al 25 Bennett et al 27 Burke et al 34 (F) Burke et al 34 (M) Christian et al 33 Cohen et al 35 de Mello et al 50 Dekkers et al 17 DPP 84 (1) Foster-Schubert et al 49 (1F) Foster-Schubert et al 49 (2F) Foster-Schubert et al 49 (3F) Haapala et al 36 Janus et al 53 Kirby et al 23 Kulzer et al 37 Langford et al 38 Lim et al 31 Ma et al 47 Martin et al 39 (F) Morey et al 46 Nakade et al 52 (F) Nakade et al 52 (M) Nanchahal et al 54 Parikh et al 45 Patrick et al 18 (M) Ross et al 28 (F) Ross et al 28 (M) Stevens et al 40 (F) Stevens et al 40 (M) Stevens et al 41 (F) Stevens et al 41 (M) ter Bogt et al 21 Vissers et al 26 (1) Vissers et al 26 (2) Wadden et al 20 Wood et al 42 (1M) Wood et al 42 (2M) Wood et al 43 (1F) Wood et al 43 (1M) Wood et al 43 (2F) Wood et al …”

A comparison of the provision of the My Choice Weight Management Programme via general practitioner practices and community pharmacies in the United Kingdom

“…33 The difficulty in inducing weight loss amongst a cohort with unique periods open so that interventions have no pre-defined end point. 14 16 22 …”