Evaluation of Weigh Forward: A group intervention delivered by dietitians and psychologists within a National Health Service specialist weight management service

Abstract

There is limited evidence of the effectiveness of non-surgical interventions for severe obesity.Our aim was to evaluate a group intervention delivered by a National Health Service (NHS) specialist weight management service to contribute to the evidence base and inform the development of future services. Participants in this prospective cohort study were patients attending NHS Grampian Specialist Weight Management Services. The intervention was an interactive 12-session group programme based on evidence-based psychological model, with combined dietetic and psychological knowledge and support provided. The primary outcome was mean weight change at the end of the intervention and for 12-mo follow-up (including programme completers, baseline observation carried forward [BOCF], last observation carried forward). Secondary outcome measures included mood, anxiety, binge eating and quality of life. A total of 166 patients accepted a place on the group programme, mean body mass index was 48.9 kg/m 2 . Mean weight loss at 6 mo was 5.6 kg and 35.2% of those who completed the group (n = 88) lost ≥5%. Using BOCF, 18.7% lost ≥5% at 6 mo. Those who remained in the programme maintained their weight loss 12 and 18 mo after the start of the intervention. Significant improvements were also found in psychological variables, including reduced depression, anxiety, binge eating and improved emotion regulation. This real-world evaluation of an NHS intervention for patients with severe obesity suggests that individuals who engage achieve a moderate weight loss, which most maintain a year later, although further research is needed to strengthen this conclusion.

Multidisciplinary pathway to support lifestyle change: tangible benefits in physical and mental health for patients with nonalcoholic fatty liver disease (NAFLD)

“…They cited a sense of being “in control” and being held accountable for their activity levels as helpful. This finding is backed up by previous research which documents that the use of step counters promotes an average increase of 2000–2500 steps per day when linked to behavior change strategies including building confidence, goal setting, self-monitoring (recording and reporting back 7-d average), problem-solving (adapting walking behavior to suit weather and setting), social support, and feedback 9–11…”

“…In comparison with other studies, the lack of significant weight change was not surprising. Previous research highlights the poor sustainability of weight loss interventions 9. Poor diet and limited physical activity are common in people diagnosed with NAFLD.…”

“…This was an evidence-based approach. [9,10] A copy of the assessment form is available (Supplemental Appendix 2, http://links.lww. com/XCL/A7).…”

“It’s changed my life!” Evaluation and improvement of a pilot Tier 2 weight management course, “Balance”

“…BMI reduced more in the intervention group than TAU with a small effect (d = 0.09). An ACT-based NHS Tier 3 intervention ( N = 166) called “Weigh Forward” has been evaluated (Moffat et al , 2019). This was a six-month programme with a one-year follow-up, and the results showed that completers ( n = 88) had a mean weight loss of 5.6 kg at the six-month follow-up, with 35.2% ( n = 31) of participants losing at least 5% of their body weight.…”

Impacts of nutrition counseling on depression and obesity: A scoping review

“…23,24 While current available research has widely examined the impact of weight loss on depressive symptoms, it has failed to assess the independent impact of nutrition on psychosocial and behavioral outcomes. [25][26][27] Given the relative novelty of this field of study, a scoping review was conducted to understand the landscape of the existing literature, including the range of methodologies used to assess the impact of nutrition counseling on the mental health of individuals affected by obesity, regardless of its effect on weight.…”