Counterweight is the only fully evaluated, evidence based primary care weight management programme within the UK - possibly worldwide.

It is a low-cost nurse-led programme which equips general practitioners and practice nurses to be able to produce evidence-based approaches to weight management. It uses a structured approach to care and an interactive model of communication which is critical to empowering patients. It was developed and piloted in 80 UK general practices between 2000-2005. 

Counterweight aims to achieve and maintain medically valuable weight loss (5-10%) for as many people as possible. It incorporates Continuous Improvement Methodology, to improve the programme through continued systematic evaluation.

Counterweight was designed to incorporate a weight management service into existing healthcare services.  It is a flexible and sustainable model and can be adapted to deliver tailored programmes to individuals, groups, or families depending on needs and level of resources available. Although evaluated in a primary care setting, it can be adapted for use in other settings.

Obesity is a major public health concern due to the burden of obesity-related disease, impaired quality of life and implications for health service expenditure now and in the future. United Kingdom (UK) prevalence data indicates that 23.8% of women and 23.6% of men in England and 26.0% of women and 22.4% of men in Scotland are now obese.  There is overwhelming and consistent evidence that obese patients with no intervention will steadily gain further weight over time.  The obese population attend general practice frequently and obesity is associated with increased prescribing costs.

The Counterweight Programme has been developed and evaluated between 2000 and 2005 and has been shown to be an effective model for obesity management within general practice.  It incorporates implementation of evidence-based pathways and strategies to empower clinicians and patients. The Counterweight Project extensively audited the burden of obesity to primary care and has published in this area. Using a system of continuous improvement methodology, findings from the Counterweight Project have been used to review and refine the programme.

The model is based on Weight Management Advisers (WMAs; dietitians specialising in obesity management), working across Primary Care Trusts (PCTs) training and supporting healthcare staff to put the Counterweight weight management programme into practice.  It is anticipated that each trained practice could enrol an average of 50 patients in a year.