Evaluation of the first phase of a specialist weight management programme in the UK National Health Service: prospective cohort study

Public Health Nutr. 2012 Jan;15(1):28-38. doi: 10.1017/S1368980011001625. Epub 2011 Aug 2.

Abstract

Objective: To evaluate the first phase of a specialist weight management programme provided entirely within the UK National Health Service.

Design: Prospective cohort study using multiple logistic regression analysis to report odds of ≥5 kg weight loss in all referrals and completers, and odds of completion, with 95 % confidence intervals. Anxiety and depression 'caseness' were measured by the Hospital Anxiety and Depression Scale.

Setting: Glasgow and Clyde Weight Management Service (GCWMS) is a specialist multidisciplinary service, with clinical psychology support, for patients with BMI ≥35 kg/m2 or BMI ≥30 kg/m2 with co-morbidities.

Subjects: All patients referred to GCWMS between 2004 and 2006.

Results: Of 2976 patients referred to GCWMS, 2156 (72·4 %) opted into the service and 809 completed phase 1. Among 809 completers, 35·5 % (n 287) lost ≥5 kg. Age ≥40 years, male sex (OR = 1·39, 95 % CI 1·05, 1·82), BMI ≥ 50 kg/m2 (OR = 1·70, 95 % CI 1·14, 2·54) and depression (OR = 1·81, 95 % CI 1·35, 2·44) increased the likelihood of losing ≥5 kg. Diabetes mellitus (OR = 0·55, 95 % CI 0·38, 0·81) and socio-economic deprivation were associated with poorer outcomes. Success in patients aged ≥40 years and with BMI ≥50 kg/m2 was associated with higher completion rates of the programme. Patients from the most deprived areas were less likely to lose ≥5 kg because of non-completion of the programme.

Conclusions: Further improvements in overall effectiveness might be achieved through targeting improvements in appropriateness of referrals, retention and effective interventions at specific populations of patients.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • Confidence Intervals
  • Depression / complications
  • Diabetes Mellitus / etiology
  • Diabetes Mellitus / metabolism
  • Female
  • Hospitals
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • National Health Programs*
  • Obesity / complications
  • Obesity / therapy*
  • Prospective Studies
  • Referral and Consultation
  • Socioeconomic Factors
  • United Kingdom
  • Weight Reduction Programs*