Evaluation of a multidisciplinary Tier 3 weight management service for adults with morbid obesity, or obesity and comorbidities, based in primary care. Issue 5 (1st July 2014)

• Record Type: Journal Article
• Authors: Jennings, A.; Hughes, C. A.; Kumaravel, B.; Bachmann, M. O.; Steel, N.; Capehorn, M.; Cheema, K.
• Is Part Of: Clinical obesity. Volume 4:Issue 5(2014)
• Page Start: 254
• Page End: 266
• Publication Date: 2014-07-01
• Subjects: Obesity -- Periodicals; Obesity -- Treatment -- Periodicals; 616.398005
• DOI: 10.1111/cob.12066
• Languages: English
• ISSNs: 1758-8103

Abstract

<abstract abstract-type="main"> <title>Summary</title> <p>A multidisciplinary Tier 3 weight management service in primary care recruited patients with a body mass index ≥40 kg·m<sup>−2</sup>, or 30 kg·m<sup>−2</sup> with obesity‐related co‐morbidity to a 1‐year programme. A cohort of 230 participants was recruited and evaluated using the National Obesity Observatory Standard Evaluation Framework. The primary outcome was weight loss of at least 5% of baseline weight at 12 months. Diet was assessed using the two‐item food frequency questionnaire, activity using the General Practice Physical Activity questionnaire and quality of life using the EuroQol‐5D‐5L questionnaire. A focus group explored the participants' experiences. Baseline mean weight was 124.4 kg and mean body mass index was 44.1 kg·m<sup>−2</sup>. A total of 102 participants achieved 5% weight loss at 12 months. The mean weight loss was 10.2 kg among the 117 participants who completed the 12‐month programme. Baseline observation carried forward analysis gave a mean weight loss of 5.9 kg at 12 months. Fruit and vegetable intake, activity level and quality of life all improved. The dropout rate was 14.3% at 6 months and 45.1% at 1 year. Focus group participants described high levels of satisfaction. It was possible to deliver a Tier 3 weight management service for obese patients with complex co‐morbidity in a primary care setting with a full multidisciplinary team, which obtained good health outcomes compared with existing services.</p> </abstract>