Counterweight Outcomes at a Glance
Findings
In the research phase of the project, a quarter of patients had a BMI ≥ 40kg/m2, 76% had at least one obesity related co-morbidity and 47% were classified as high attenders. Mean weight change at 12 months was -3.0kg in all patients (n=642, p<0.001) and -4.3kg in high attenders (n=422, p<0.001). At 24 months weight change was -2.3kg in all patients (n=357, p<0.001) and -3.3kg in high attenders (n=225, p<0.001). Thirty percent of all patients enrolled and followed up in the programme and almost forty percent of high attenders maintained ≥5% loss at 12 months.
Obesity-related cardiovascular disease (CVD) risk factors improved in the whole cohort.
Interpretation
The Counterweight Programme is an effective evidence-based model for improving the management of adult obesity and associated CVD risk in primary care.
- Moderate weight loss brings significant clinical benefit
- Counterweight provides a pragmatic model for the management of obesity
- Weight loss outcomes compare favourably with higher cost RCTs
Effect of Counterweight Intervention on Prescribing Costs
By applying the mean change in BMI observed in the pilot phase of Counterweight to the costs of prescribing at varying BMI levels expected savings can be estimated. These savings were 6.3% of prescribing costs for all patients and 8.4% of prescribing costs for patients whose attendance with the programme was optimal. Attributable prescribing costs of obesity were calculated by applying cost at BMI> 30kg/m2 minus cost at normal weight, multiplying up by the population of the UK and showing as a proportion of total prescribing costs.
- 16% of the total prescribing costs can be attributable to obesity
- 26% of the total prescribing costs can be attributable to overweight and obesity
After applying the % savings estimated from weight loss observed with the Counterweight Programme, it can be concluded that in year 1 alone, 10% of the cost of the programme can be offset through prescribing savings (this figure increasing to 25% when programme attendance and follow-up is optimal)
Longer Term Cost Effectiveness
- Applying the NICE model to evaluate the long term impact demonstrates that providing Primary Care obesity management is cheaper and more effective than providing no weight management intervention.
- Prescribing costs increase with increasing BMI
- Weight change outcomes observed in the Counterweight programme will bring associated cost savings
- One quarter of all prescribing costs can be attributed to overweight and obesity
- Longer term analysis shows that providing Counterweight is cheaper and more effective than doing nothing