Counterweight uses a theoretical Evidence Based Quality Assessment model of continuous improvement to meet its aim of improving the management of overweight and obesity in adults (18–75 years) in various settings by achieving medically valuable weight loss 5-10% (5-10kg) and sustaining this weight loss at 2 years. 

Prior to developing Counterweight there was no documented audit of a weight management programme in primary care in the UK. The programme was founded on evidence based elements (e.g. for diet composition, exercise, methods and duration of delivery) but there was no existing model of accepted practice or best practice.

For that reason, there could be no “control” arm for a comparative study. Instead, the Counterweight Programme used evidence founded methods, based on the 1996 SIGN guidelines and generated the first evidence base for a comprehensive weight management service in primary care.

Future research will now be able to use the current Counterweight Programme as a fully evidence based model of good practice, from which to evaluate new, improved, components.

Key elements in the current evidence base are:

  • Minimal interventions e.g. email, flagging patients records and casual advice, are ineffective in generating weight loss or maintenance
  • Effective interventions have not yet been developed for children
  • Modest weight loss (5-10 kg) achieved by any intervention is effective in improving all CVD risk factors, except hypertension which often recurs despite weight loss maintenance
  • The Counterweight Programme is effective in providing >5% loss at 12-24 months for about 16% (1 in 6) of patients who enter the programme
  • Of those who attend 2/3 of appointments or more, about 50% are successful in losing and maintaining weight loss >5%
  • 10-20% of patients receiving anti-obesity drugs as part of the Counterweight Programme
  • The current Counterweight Programme is highly cost-effective. Reduced prescribing costs for successful patients are projected to out-weigh the total cost of providing the Counterweight Programme
  • Conventional weight management in primary care is not effective for treatment of severe and complicated obesity when loss of >15 kg is required.

This evidence makes the Counterweight Programme a succesful lifestyle weight management programme for sustainable weight management in primary care and other settings.