Abstracts / Posters
Effectiveness of weight management interventions in UK primary care: the Counterweight Programme
The International Association for the Study of Obesity. Obesity Reviews. 2006 7 (Suppl 2). p78-79.
The Counterweight Project Team
Background: Specialist dietitians facilitated implementation of an evidence-based pathway for the management of obesity in 65 general practices in 7UK areas. First-line was lifestyle intervention delivered in six individual appointments or six group sessions over 12 weeks. Second-line interventions were additional lifestyle intervention or pharmacotherapy (orlistat or sibutramine). The impact of interventions on likelihood of patients losing >5% weight at 12 months was assessed in all patients, ‘high attenders’ (>6 visits in 12months) and ‘low attenders’.
Results: At 12 months the proportion of patients achieving >5% weight loss was 33.7% for individual vs. 24.4% for group (P=0.347). However attendance rates were better with individual compared to group intervention. The was 53% ‘high attenders’ in the individual intervention compared with 37.8% in groups (P<0.0001). ‘High attendance’ was associated with improved weight loss, 37.9% of ‘high attenders’ compared with 19.1% ‘low attenders’ achieving >5% weight loss (P<0.0001). The addition of pharmacotherapy was associated with improved weight change outcomes but only in ‘low attenders’: 31.1% of ‘low attenders’ receiving pharmacotherapy achieved weight loss of >5% compared with 16.6% receiving no pharmacotherapy (P =0.027). There was no significant advantage from the addition of pharmacotherapy in the ‘high attenders’ group.
Conclusion: Compliance with the Counterweight Programme, as judged by attendance rates, was associated with greater weight loss with a trend for better results for individual rather than group intervention. The impact of pharmacotherapy in ‘low attenders’ warrants further attention.