Endocrine Abstracts

Background: In a research setting, complex behavioural interventions are effective in changing lifestyle behaviour and inducing weight loss. However, these are viewed as requiring a high number of different health care professionals to be successful and thus few are available in the NHS setting. Here we describe how we developed and piloted a complex behavioural intervention for participants with severe morbid obesity.

Methods: Using input from a psychologist, physician, dietitian and nurse practitioner a 6-month weight management programme comprising dietary modification, behavioural change, exercise and record keeping was devised for morbidly obese patients.

After physician assessment, goal setting and written contract, patients were enrolled into the course in classes of 10 and provided with calorie controlled, ambient temperature meals together with a dietary prescription, a pedometer and walking programme and a journal/folder for class notes. They attended weekly and then fortnightly 1-hour long behavioural change classes run by experienced weight-management health educators. The PCT funded the course and the starter pack of meals for 2 weeks with patients then purchasing their ongoing food supplies.

Results: To date 26 of 34 (76%) participants completed the 6-month course. Of these eight were male, average age 48 (range 31–78). Average start weight was 130 kgs (+22.8 kg), BMI 45 (+6.9). Weight loss after 6 months was 13.5 kgs (+6.1 kg). 96% of participants achieved 5% total body weight loss and 46% achieved 10%.

Conclusion: The new start programme has a high retention rate suggesting that its format and the way it is delivered is well received by the participants. It is also very effective, achieving greater percentage weight loss than any of the current licensed medications. Further data is required to confirm this and follow up of patients required to asses longer term outcomes.