Endocrine Abstracts

Introduction: The NHS Commissioning Board recommends the introduction of multidisciplinary Tier 3 Specialist Weight Management Services (SWMS) for adults with obesity. Unfortunately, these services are yet to be commissioned in many areas and this largely reflects financial barriers to their development. We have noted, through observation and feedback, that our Tier 3 service is highly valued by patients. Supportive evidence in the literature - although encouraging - is limited. In the current financial climate, it is important that long-term data are collected in order to evaluate the wider effects of implementing such services.

Methods: Retrospective service evaluation of all patients (n=179) engaging with the Central London Community Healthcare SWMS for at least 6-months from 2011 onwards. Outcome measures, including weight, Body Mass Index (BMI), blood pressure, HbA1C, Epworth Sleepiness Scale (ESS) and measures of QoL (EQ-5D-3L) and anxiety and depression (GAD7, PHQ9) were collected at baseline and then at 6-monthly intervals during the patient’s period of engagement with the service. Data collection is ongoing and provisional analyses of the first 46 patients are detailed.

Results: The mean time from baseline assessment to first follow-up was 187.9 days. There was a significant reduction in weight (mean 1.8 kg, P=0.002) between baseline and first follow-up, with an associated reduction in BMI (mean reduction BMI 0.9, P=0.001). Reductions between baseline and follow-up ESS and PHQ9 scores were also noted although these findings did not reach statistical significance.

Conclusions: Provisional results confirm that a Tier 3 SWMS can achieve weight loss through lifestyle changes. The noted trends in reduction of ESS and PHQ9 scores, the latter of which was also noted in previous local work (PHQ9 scores improved in up to 74% of patients) suggest that these services may also provide a positive effect on an individuals’ overall wellbeing. This warrants further study.