Evaluation of a multimodality treatment programme for weight management at the Luton and Dunstable Hospital NHS Trust

Abstract

Background: The evaluation concerns a 12‐week group treatment programme providing formalized behaviour and cognitive modification combined with an initial low calorie liquid diet offered through a specialist NHS Obesity Clinic. Aims: The aims of this evaluation were to: (1) determine the success of the programme in terms of: (a) producing medically significant weight loss for up to 18 months after the programme; (b) psychological and social benefits for patients; (2) identify factors predictive of weight loss and the likelihood of completing the programme. Methods: A retrospective evaluation was undertaken of 12 groups of patients (115 patients), referred by their General Practitioners to the Obesity Clinic for advice and treatment of obesity. Data were obtained from initial assessment questionnaires, clinical notes and a follow‐up questionnaire. Results: The evaluation showed that the programme was successful in helping patients achieve medically significant weight loss (on average 12% of initial body weight) and to partially maintain some weight loss for up to 18 months after. In addition, there were measurable psychological and social benefits from their adherence to the programme. Only the mental state of the patients at the start of the programme was predictive of the likelihood of their managing to complete it. Conclusion: The progamme can be effective in achieving and maintaining weight loss. Patients may benefit psychologically. Patients may have an improved likelihood of completing the programme if depression is treated first.

Predictors of programme adherence and weight loss in women in an obesity programme using meal replacements

“…During this phase, subjects were given a weight-maintenance regimen including group dietetic and lifestyle therapy, behavioural modification and advice on increased physical activity based on the CHANGE programme [14]. Dietary advice was modified to allow the use of at least 10 SlimFast ready-made liquid or powder MR each week provided free.…”

Corrigendum: Bariatric surgery, lifestyle interventions and orlistat for severe obesity: the REBALANCE mixed-methods systematic review and economic evaluation

“…Randomised controlled trials constituted 30.7% of the 26 included reports, 95,96,117,128,142,149,167,234 including a 9-month RCT after a 3-month non-randomised screening period; 7.6% were non-randomised comparative studies 240,241 and 57.7% were non-comparative studies. [241][242][243][244][245][246][247][248][249][250][251][252][253][254][255][256] Sixteen per cent were published before or during 2000, 117,167,243,244 44% were published between 2001 and 2010 95,96,234,240,241,[245][246][247][248][249][250] and 40% were published from 2011 onwards. 128,142,149,242,[251][252]…”

“…128,142,149,242,[251][252][253][254][255][256][257] Fifteen studies had follow-up of 12 months, 95,96,117,128,142,149,167,241,243,245,246,249,251,253,255 one had follow-up of 15 months, 247 two had follow-up of 18 months, 234,244 six had follow-up of 24 months, 242,248,250,252,254,256 one had follow-up of 36 months 257 and one of 60 months. 240 One study was a community-based intervention (Scottish Premier League football clubs), 128 40% took place in primary care, 142,149,167,234,243,246,[249][250][251]253 12% took place in both primary and secondary care invest...…”

“…240 One study was a community-based intervention (Scottish Premier League football clubs), 128 40% took place in primary care, 142,149,167,234,243,246,[249][250][251]253 12% took place in both primary and secondary care investigating orlistat, 95,96,117 11 took place in secondary care (one took place in a nephrology clinic, 252 three took place at diabetes mellitus clinics, 240,245,248 seven took place at specialist weight-management clinics 241,242,244,247,[254][255][256] and one took place in a commercial setting 257 ). In terms of location, 61.5% took place in England, 142,149,167,234,240,[242][243][244][245][246][247][248][249]254,256 15.4% took place in Scotland 128,251,253,…”

Pre‐pregnancy weight loss in women with obesity requesting removal of their intra‐uterine contraceptive device in order to conceive: a pilot study of full meal replacement

“…The present study was designed to assess the willingness of women with obesity to delay removal of their IUCD in order to reduce their weight prior to conceiving to potentially improve their health and the outcomes of a future pregnancy. Women with obesity were asked to participate in an intensive weight management programme (IWMP) compromised of an initial 8-week total diet replacement low energy diet in order to reduce weight by 10% or greater (6). Total diet/meal replacement programmes, followed by gradual reintroduction of food have been extensively developed through continuous improvement methodology and offered within UK National Health Service Tier 3 (specialist) obesity clinics and shown to induce weight loss in excess of 10% in a mixed population of patients and is used in NHS clinics.…”