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Overcoming Obesity One Patient at a Time – Annals of Family Medicine
We have developed an innovative office-based weight loss program that inspires patients to achieve long-term weight loss by making small, incremental diet and lifestyle changes.
Our practice consists of 2 family physicians and 1 family nurse practitioner. Our behavioral intervention program uses the 5 As of Behavior Change model1 and is based on Change Control Diet,2 by Harry H. Suiter, who himself struggled with weight management for decades. In collaboration with Mr. Suiter, we have developed a formal office-based weight loss program with Mr. Suiters book for the patient, a health care providers guide (Supplemental Appendixes 1 and 2), and webinar modules3 to help other practices implement this program and achieve the same successes our patients have experienced.
Unlike traditional weight loss programs, we focus on small changes over time. We do not prescribe diets or medications, and the program does not require a formal education in nutrition to administer. A physician or nurse practitioner meets one-on-one with the patient and directs him or her through the self-managed program. Our experience is that patients need 6 to 10 office visits to learn the program before continuing to apply its principles on their own. We bill for these visits with preventive counseling or chronic disease management codes. Treating obesity as a priority problem at office visits allows us to focus on patients current eating and activity choices and introduce small improvements.
We initially teach patients to lose weight with their current food choices by using basic calorie counting. Not being asked at the outset to eat healthy as well as to eat less reduces their initial stress. The health care providers guide gives the clinician talking points and handouts for patients to use in self-monitoring.
We spend initial visits educating patients on calorie counting and nutrition, and we start them on a food diary. Then, after thoroughly evaluating their 7- to 10-day food diaries, we start leading them through small changes until they master the principles of the program. These include eating a set number of meals and snacks throughout the day, aiming for a daily caloric intake goal consistent with the patients sex, age, and activity level, increasing physical activity by small increments, and learning how to manage stress and think positive. Follow-up visits focus on changing habits, increasing self-efficacy, and engaging family and friends. In our pilot program with 39 patients, including 15 with prediabetes and 9 with diabetes, the mean baseline weight was 241.59 pounds, (SD 47.19 pounds). The mean weight change for participants completing at least 3 months of follow-up (N=39) was 6.96 pounds (SD 10.19 pounds; P <.001) and the mean change in HbA1C values for patients with prediabetes or diabetes was 0.33 (SD 0.61; P = .045).
In developing this program we have learned many valuable lessons, in particular that making small changes and losing weight gradually is more likely to succeed than making major changes to achieve major initial weight loss. Patients appreciate the one-on-one guidance we provide. Some have lost more than 20 pounds, which has improved their mental and physical health, resulting in outcomes such as reduced HbA1C levels and decreased diabetic medication. Finally, this program can benefit all involved parties. Patients learn self-management strategies and improve their health. Clinicians learn how to counsel patients about obesity while developing personalized healing relationships and learn how to bill insurance companies for the office visits. Practices improve reportable quality metrics. Finally, health insurance companies and health systems reduce medication costs, emergency department visits, and hospitalizations for comorbid diseases.
Conflicts of interest: Jeanne M. Ferrante reports none. Ronald M. Frank and Clair L. Carragino have a financial relationship with Change Control Diet, LLC, which is based in part on revenue of the program.
Author affiliations, references and supplemental appendixes are available at http://www.AnnFamMed.org/content/15/3/280/suppl/DC1/.
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Overcoming Obesity One Patient at a Time - Annals of Family Medicine
There’s More to Mama June’s Weight Loss Than Meets the Eye – TVOvermind
Whether you (secretly) love Mama June or cringe every time you hear her name, you have to admit that Mama June Shannons dramatic weight loss has completely transformed her appearance for the better. If you havent been following her weight loss journey on WE TVs Mama June: From Not to Hot, you may not be familiar with how she managed to drop 300 pounds. The truth is that even if you have watched every second of the show, there are several things you might not know. Here are 5 things you were never told about Mama Junes weight loss.
There was more to her weight loss than just diet and exercise.
After losing 90 pounds, Mama Junes weight loss plateaued and she began to experience fainting episodes. With a goal of losing at least 80 more pounds, she opted to undergo gastric sleeve surgery. This procedure involves taking out around 80% of the stomach, though the digestive tract stays intact, unlike gastric bypass surgery. While this procedure is permanent, shell still have to exercise and eat healthy or run the risk of regaining the weight she lost.
To perfect her look, she underwent over $75,000 worth of surgery.
In addition to having 9 pounds of loss skin removed from her stomach, bat wings (sides of her arms), and turkey neck, Mama June also underwent a variety of plastic surgery procedures. They include liposuction around her neck and on her face, a tummy tuck, and breast implants and a lift. She also had porcelain veneers placed on her teeth. Finally, she had a procedure referred to as cool sculpting to get rid of her double chin.
She didnt rely on anyone else for help with her medical bills.
In an interview with the Dominic Nati Show, Mama June was quick to point out that she alone was responsible for the costs of her surgery. She said, I had to pay, just like everybody else. Of course, she did receive money from WE TV for appearing on the show, which made it easier for her to afford the procedures. On the other hand, no one has revealed how much she was paid for doing the show.
Shes joined a support group.
Although she was nervous about walking into a room of people I dont know and talking about my overeating, Mama June decided it was necessary to join an overeaters support group to help maintain her weight loss long-term. She opted for a small support group, which was particularly beneficial after she fell off the wagon due to the stress of Sugar Bears upcoming wedding.
Her weight loss has taken a (positive) toll on her emotional health.
Although Mama June admits that her weight loss was initially motivated by revenge and a desire to make Sugar Bear kind of jealous, thats no longer the case. Now, shes motivated because I dont want to disappoint everybody and not be the skinny Mama June that everybody is looking forward to. it cant be about making everyone happy its got to be about me.
So, what do you think? How does Mama June look and more importantly, will she be able to maintain her weight loss?
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There's More to Mama June's Weight Loss Than Meets the Eye - TVOvermind
Guest Column – Diet Center’s Weight Loss Tip of the Week: Why do I do this to myself? – Kdminer
One reason why people turn to food is to avoid facing unpleasant emotions. Hi, this is Eunice with Diet Center.
It can be very difficult to face our feelings, and a lot easier to take comfort in food. Ignoring our feelings wont make whatever is bothering us go away. Identifying your feelings will help you understand what you are experiencing so that you can address a situation and improve it. Enduring unpleasant emotions is necessary in order to process them.
The next time you feel the urge to binge or indulge yourself to feel better, try facing your feelings first. Think about what is causing you to feel the way you do, and how you can improve the situation without food. You may need to cry, turn to a friend, or address the actual situation or person that is making you unhappy.
Then there are those of us that celebrate with food.
Many significant events in life are celebrated with food. Food is also there when everyone else has left. Is it any wonder that our unconscious mind associates food with comfort, control, acceptance, self-worth, confidence, or happiness? Food doesn't provide any of these things.
There are many sensory associations that trigger certain eating behaviors. For example, many people desire something sweet after dinner. It may be that after you eat something savory that taste on your palette triggers an association for something sweet.
You can retrain your palette!
Whenever you have the feeling that you just have to eat something sweet after dinner, it may be that your unconscious mind has linked flavors and sensory data to initiate this behavior. You can retrain your palette by making a conscious effort to practice new behaviors. Instead of eating sweets, drink water, brush your teeth, or begin some other enjoyable activity that doesnt involve food.
In addition, you should know what youre eating. Keep a food diary, and write down everything that you eat. This will help make your conscious mind aware of what you are eating. When you know what is good for you and practice good behaviors, you can retrain your mind to help you achieve your goals.
Setting goals are important to your long-term success. Successful people set goals to monitor their progress and motivate themselves to accomplish tasks important to them. It is important that your goals are truly yours. Think about the goals you have set for yourself. Who benefits most from these goals? Are you striving to please your spouse, friends, family, or doctor? Maybe your goals were set as a result of someone elses prompting and not your own ideas.
For example, are you trying to lose 10 pounds because your doctor said you should? You will only succeed at achieving your weight loss goals if you find meaningful reasons for making changes in your lifestyle.
Thank you for reading Diet Centers tip of the week. If you are struggling with weight loss, please call me today at 928-753-5066, or stop by at 1848 Hope Ave. in Kingman.
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Guest Column - Diet Center's Weight Loss Tip of the Week: Why do I do this to myself? - Kdminer
Significant Improvement in Glycemic Control With Weight Loss Intervention – Monthly Prescribing Reference (registration)
May 06, 2017
Baseline average in the phentermine group was 229.6lbs vs. 209.7lbs in the OPTIFAST group
This article is written live from the American Association of Clinical Endocrinologists (AACE) 2017 Annual Meeting in Austin, TX. MPR will be reporting news on the latest findings from leading experts in endocrinology. Check back for more news from AACE 2017.
A medically supervised weight loss program over 6 months led to a significant improvement in glycemic control, presented Jonathan Allen, MS, RD, from the North Florida Regional Thyroid Center, at the AACE 2017 Annual Meeting.
The rise of obesity over the past 40 years has brought with it a significant rise in prediabetes and type 2 diabetes, carrying health, financial, and social burdens. A loss of 5% of body weight has demonstrated significant improvements in blood pressure, lipid levels (eg, HDL, triglycerides), and blood sugar. A loss of 1015% of body weight has also demonstrated a higher likelihood of achieving health improvements.
Weight loss recommendations start with an initial lifestyle modification, including improved dietary intake and more physical activity. Medication therapy is also available for patients who have severe comorbidities as are medically supervised meal replacement programs when major dietary interventions are warranted.
Allen and colleagues conducted a retrospective study to assess phentermine and the OPTIFAST diet program on weight and diabetes outcomes at 6 months. They reviewed 15 patients who completed treatment with phentermine and 6 patients who completed 6 months of the OPTIFAST program with HbA1c >6%. At baseline, the average in the phentermine group was 229.6lbs vs. 209.7lbs in the OPTIFAST group.
The analysis showed a significant effect on HbA1c where phentermine therapy led to a 0.06% increase vs. a 1.8% decrease with OPTIFAST (P<0.001). There was a 50.3lbs (17.9%) decrease in weight among phentermine patients vs. 13.6lbs (6.0%) decrease in weight among the OPTIFAST patients. Moreover, one-third of the patients in the phentermine group had a decrease in antidiabetic medications and all participants in the OPTIFAST decreased antidiabetic medications by 50% or discontinued completely.
In general, improved glycemic control was seen following a 6-month, medically supervised meal replacement weight loss program. "Despite reduced or discontinued diabetes medication, sustained weight loss promotes improvements in long-term blood glucose control," concluded Allen.
For continuous endocrine news coverage from the AACE 2017 Annual Meeting, check back to MPR'sAACE pagefor the latest updates.
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Significant Improvement in Glycemic Control With Weight Loss Intervention - Monthly Prescribing Reference (registration)
Online weight loss plans – Wikipedia
Online weight loss plans are web-based fitness programs designed to help participants lose weight. These may include assistance in the areas necessary for weight loss such as goal setting, progress tracking, meal and workout planning and personal support from personal trainers or fitness coaches.
Online weight loss plans are usually interactive programs that provide the user with diet information, workout routines, meal planning, goal tracking, and feedback. Web-based programs usually attempt to incorporate all of these areas and customize them for a particular user. The user will usually fill out a questionnaire before proceeding. The questionnaire will contain information such as current eating patterns, fitness levels and goals.
A personalized meal plan and workout program are usually created for the user. One feature of these programs is the use of online tools to track improvements, and to log workout and diet information. The idea behind these tracking tools is that by tracking fitness, a person can make more progress by aiming for and meeting regular fitness goals. Programs range in price from the very basic, to highly customized programs created by celebrity fitness experts. There are also free web-based programs. While they usually provide access to online tools, they may not provide any customized plans.
Online weight loss plans usually contain some of these elements:
In a year-long study published in the Journal of the American Medical Association, participants of an online weight loss plan lost more than twice the weight of participants who took part in a more traditional program. It has been shown that people who have used online weight loss plans for 18 months were able to maintain significant weight loss.[1] Many studies now show that Internet programs are viable tools to help people maintain weight loss over the long term. In one study, a group of 250 people lost weight over a six-month period and maintained weight loss for 12 months afterwards using an online weight loss plan.[2] The low cost combined with the lack of need for face-to-face meetings with a nutritionist or personal trainer make Internet programs easy to maintain long-term loss. The requirement of constantly updating weight and other measurements helps to hold the user accountable as well. This could help people maintain weight loss over a long period. Many studies even show that participants that logged into their online programs more also experienced, on average, more weight loss. There has been an upsurge of companies specifically dealing with only online weight loss. There has recently been research into the effectiveness of web-based weight loss programs in primary care settings.[3]
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Online weight loss plans - Wikipedia
Extending weight loss programme helps overweight people keep … – Medical Xpress
May 4, 2017 Credit: Quinn Dombrowski
Extending NHS weight loss programmes from one session per week for 12-weeks to one session per week for a year helped people who are overweight to lose more weight and keep it off for longer, according to a study published in The Lancet, and led by researchers from the University of Cambridge, University of Liverpool and University of Oxford.
Although upfront costs for the longer programme are higher, the study estimates that offering more sessions would be cost-effective to the NHS in the long-term because it would help to prevent more people from developing diseases as a result of their weight.
"This trial provides important data that offering support to lose weight by referring people to a community weight loss group is more successful than a self-help approach, and that providing classes for longer helps people keep weight off for longer," says Professor Susan Jebb, senior author of the study from University of Oxford. "Our results also show that, in the long-term, weight loss groups are cost-effective for society as a whole because they are likely to reduce future healthcare expenditure by preventing costly conditions such as diabetes and coronary heart disease."
The NHS currently refers people who are obese to 12-week long weight loss programmes run by commercial groups and provides vouchers for free attendance. These are among the most commonly commissioned programmes to treat obesity in the UK and the National Institute for Health and Care Excellence recommends that programmes last at least 12 weeks. However, there is little evidence to suggest how long these programmes should last to be most effective.
The new study involves 1,267 participants with a body mass index (BMI) of 28 or above and compares the effectiveness of a 12-week and a year-long programme of free Weight Watchers sessions to one-off advice together with a self-help booklet.
After a year, those given the self-help booklet had lost 3.3kg, those referred to the 12-week programme had lost 4.8 kg, and those referred to the year-long programme had lost 6.8kg on average. Two years after they began treatment, participants in all groups regained some weight but all groups were still lighter on average than at the start of treatment. The self-help group were 2.3kg lighter, the 12-week programme were 3.0kg lighter, while the group offered a one-year programme were 4.3kg lighter.
Compared to participants in the other groups, those in the year-long programme also had significantly greater reductions in fasting blood glucose and glycosylated haemoglobin, which are important markers of the risk of developing diabetes. After a year, those on the year-long programme saw their blood glucose level reduce by 0.54mmol per litre of blood (compared to reductions of 0.27mmol/litre for the 12-week group and 0.11mmol/litre for the self-help group).
The researchers also modelled the impact of the three programmes over the next 25 years to predict how many people would develop different weight-related illnesses. They also estimated the impact of the programmes on quality of life, the cost of providing the programmes, as well as cost-savings to health services from preventing future diseases.
The 12-week programme was predicted to prevent more illnesses than the self-help intervention due to greater weight loss. Over 25 years, the cost to the NHS of providing the programme would be more than offset by the later savings as a result of reductions in disease, making it overall cost-saving.
Offering a year-long programme was estimated to prevent an additional 1,786 cases of disease (including 642 fewer cases of hypertension, 373 fewer cases of diabetes and 104 fewer cases of heart disease) for every 100,000 people, compared to the 12-week programme. So, although it was more expensive upfront, the study shows that the year-long programme is cost-effective over 25 years by preventing more cases of weight related illness.
"We've seen before that a 12-week programme can help people lose weight, but for the first time we've shown that extending this to a full year leads to greater weight loss over a longer period and a lower risk of diabetes," says lead author Dr Amy Ahern from the MRC Epidemiology Unit at The University of Cambridge.
"Although the initial costs of the year-long programme are greater, it's very likely that it will be good value for money over the long term because of the reduction in weight-related illnesses. The results from the one-year programme are comparable to what has been seen in previous trials that used much more costly interventions, usually involving multiple contacts with health professionals."
Professor Jebb adds: "We know that many local authorities are questioning how best to spend their limited budgets. We have shown that the longer programmes bring greater benefits, with only modest extra costs. But at a time when some areas are reducing their expenditure on obesity treatment, the first step is to ensure that people who want help to lose weight have access to at least a standard 12-week weight loss programme, which we have shown is likely to be cost-saving for the NHS."
Explore further: Commercial schemes are key to weight loss success, study finds
More information: Amy L Ahern et al. Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial, The Lancet (2017). DOI: 10.1016/S0140-6736(17)30647-5
Journal reference: The Lancet
Provided by: University of Cambridge
Public health authorities should consider commissioning a range of commercial weight loss programmes to help in the fight against obesity, University of Birmingham researchers have found.
A study of over 33,000 people, published today in the journal BMC Public Health, indicates that public health strategies that aim to prevent adult weight gain in the whole population have the potential to prevent twice as ...
Commercial weight loss programmes are more effective and cheaper than primary care based services led by specially trained staff, finds a study published on bmj.com.
Tackling obesity by offering the opportunity to attend a weight loss programme during a routine consultation is effective, welcomed by patients and takes 30 seconds of physicians' time, according to a new randomised trial ...
A weight loss program that incorporates a maintenance intervention could help participants be more successful at keeping off pounds long term. Researchers found that a primarily telephone-based intervention focused on providing ...
New research, led by the University of Southampton, has found that an online behavioural counselling tool is effective at helping people lose weight.
Extending NHS weight loss programmes from one session per week for 12-weeks to one session per week for a year helped people who are overweight to lose more weight and keep it off for longer, according to a study published ...
Young children who recognize food name brands, such as Lucky Charms, M&M's and Cheetos, often eat unhealthy items that lead to their high body mass index.
NIH discovery in mice could lead to new class of medications to fight mid-life obesity
Family structure including regular bedtimes, mealtimes and limited screen time appear to be linked to better emotional health in preschoolers, and that might lower the chances of obesity later, a new study suggests.
It is unclear whether mindful eating can help with weight loss, according to a new City, University of London review.
For decades, American waistlines have been expanding and there is increasing cause for alarm. Researchers from the Charles E. Schmidt College of Medicine at Florida Atlantic University make the case that metabolic syndromea ...
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Extending weight loss programme helps overweight people keep ... - Medical Xpress
Every-other-day fasting isn’t any better for weight loss than just eating less – Washington Post
By Linda Searing By Linda Searing May 5 at 3:08 PM
The question
Fasting has gained some popularity as a weight-loss tactic, generally practiced intermittently or on alternate days. But is it a viable alternative to the standard method of restricting calories consumed daily?
This study
The study included 100 adults, more women than men, who averaged 44 years old, were obese and relatively sedentary. They were randomly assigned to one of three groups: For six months, one group restricted daily calorie consumption to 75 percent of their normal amount. A second group fasted on alternate days by consuming only 25 percent of their normal amount of calories on those days and consumed extra calories (125 percent of normal) on the other days (which were called feast days). The third group made no changes to their normal eating pattern. For the next six months, the goal for all participants was to maintain their weight where it was at the end of the first six months. Throughout the study, participants were asked to not change their daily physical activity habits. After a year, weight loss was essentially the same 5 to 6 percent, on average for the group that restricted calories daily and the group that fasted on alternate days. Those who did not change their eating habits recorded, on average, a slight gain. More people dropped out of the study from the fasting group than from the daily-calorie-restriction group (38 percent vs. 29 percent), primarily citing trouble adhering to the fasting regimen.
Who may be affected?
People trying to lose weight. More than 70 percent of adults in the United States are overweight or obese, which can contribute to a number of health problems. Excess weight has been shown to play a role in such diseases as diabetes, heart disease, arthritis and some types of cancer. Although a plethora of weight-loss programs and methods exist, plans with long-term success rates tend to be those in which participants take in fewer calories and burn more through physical activity.
Caveats
All participants were obese; whether the weight-loss methods would have the same effect on other people was not tested. Some of the eating data came from records kept by the participants. The weight-maintenance period was relatively short. Participants were provided with food for all their meals for the first six months and then met weekly with a dietitian or nutritionist to learn how to continue the eating plan on their own.
Find this study
Online in JAMA Internal Medicine (jamainternalmedicine.com; click New Online).
Learn more
Information on choosing a weight-loss program can be found at niddk.nih.gov (search for choosing weight loss). Learn more about the effects of weight on health at cdc.gov (search for healthy weight).
The research described in Quick Study comes from credible, peer-reviewed journals.
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Every-other-day fasting isn't any better for weight loss than just eating less - Washington Post
Nutrition myths debunked – Sequoyah County Times
We had 10 ladies attend our meeting this week. Shirley was our biggest loser with 3.4 pounds lost this week. Keep up the great work Shirley. We had a net loss of 6 pounds this week. Doing great ladies!
Our Yes-Yes for the week is to eat an apple a day to keep the doctor away.
Our program was on Nutrition Myths Debunked. Examples of weight loss myths are Fad diets work, skipping meals help promote weight loss, carbohydrates are fattening, eating at night will cause weight loss, and eating less than 1,000 calories will help lose weight for good. Reality checks proved these to be myths.
Our leaders challenge this coming week is become a diet myth sleuth. Identify any advertisement that seems too good to be true. This can be from a magazine, television, the internet, etc. Make a list of reasons why the diet advertised will not work in the long term. Then, identify healthy ways to lose weight. Weight loss takes hard work and motivation.
The two-bit jar weekly contest was won by Laura.
We started our May Flower contest tonight. We receive a flower petal for every half-pound we lose. Who will get their flowerpot full of flowers first? Lets go girls.
We are preparing for State Recognition Day in Tulsa May 4-6, at the Southern Hills Marriott on 71st Street. We will meet at Cornerstone Tabernacle to carpool to Tulsa.
We would love to get to know you. You are welcome to join us in getting healthy by contacting Billie at 918-489-2155 or Shirley at 918-571-3353. Or, drop in on Thursday evenings at the Cornerstone Tabernacle at 401 W. 8th St., Gore. We meet from 5 to 7 p.m. Looking forward to meeting you. Billie.
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Nutrition myths debunked - Sequoyah County Times
Extending weight loss program helps people who are overweight … – Science Daily
Medscape | Extending weight loss program helps people who are overweight ... Science Daily Extending NHS weight loss programs from one session per week for 12-weeks to one session per week for a year helped people who are overweight to lose ... Year of Weight Watchers Best for Weight Loss, Costs, Disease Risk Extending weight loss programme helps overweight people keep ... |
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Extending weight loss program helps people who are overweight ... - Science Daily
Community weight loss programmes should be more widely … – The Conversation UK
Community weight loss programmes, such as Weight Watchers, are effective at helping people to lose weight, our latest research shows. We found that a three-month programme helps people lose weight, but a one-year programme helps people lose more weight for longer and reduces their risk of developing type 2 diabetes. Wider availability of these programmes could help people avoid metabolic diseases, such as diabetes, and may even save the NHS money in the long run.
Obesity increases peoples risk of developing illnesses such as type 2 diabetes, heart disease and some cancers. In the UK, where almost two-thirds of adults are overweight or obese, some GPs are tackling this problem by referring their patients to community weight loss programmes.
The UKs National Institute for Health and Care Excellence (NICE), the agency that decides which medicines and treatments are appropriate for the NHS to fund, recommends that adults who are obese are referred to a structured weight loss programme for at least three months. The NICE guidance specifically highlights community weight loss programmes as both cost-effective and evidence-based interventions. However, research published in BMJ Open in 2015 revealed that over a seven-year period only 6% of obese adults received a referral to any form of weight management service, let alone an evidence-based programme.
Low referral rates can be partially explained by the reluctance of GPs to raise the issue of weight with their patients and a lack of confidence in the effectiveness of these programmes. But even when GPs are willing, there are limited services available to refer patients to. Coverage of weight management services across the UK is patchy and the quality of the services is variable.
In our study, published in The Lancet, we compared the effectiveness and cost-effectiveness of three treatment options: referral to Weight Watchers for three months, referral to Weight Watchers for one year, and a brief intervention (one-off advice together with a self-help booklet).
We recruited 1,267 overweight or obese adults from 23 GP clinics across the UK and randomly allocated them to one of the three interventions. Over a two-year follow-up, those who were referred to Weight Watchers lost more weight than those who were in the self-help group. And those in the one-year programme lost more weight than those in the three-month programme.
A year after the intervention ended, those in the one-year programme had lost on average 6.8kg, compared with 4.8kg in the three-month group, and 3.3kg in the advice and self-help group. At two years, all groups had regained some of the weight, but those given a year-long programme were still lighter than the other groups. Those in the year-long programme had lost 4.5kg since the trial started, compared with 3kg in the three-month programme and 2.3kg in the brief intervention group.
Compared with participants in the other groups, those in the year-long programme also had significantly greater reductions in fasting blood glucose and glycosylated haemoglobin, which are important markers of the risk of developing diabetes.
To understand the long-term cost-effectiveness of these programmes, we modelled their impact over 25 years. Modelling uses assumptions as well as hard data, which might cause scepticism, so in our modelling we tried to make conservative assumptions such as assuming that all weight lost was regained after five years and that the full cost of the programme was incurred if people attended one session (when in practice this might not be the case).
With this model we found that, compared with the self-help group, the three-month programme achieved greater reductions in weight-related illnesses. Cost-savings on NHS treatment outweighed the cost of the programme a net saving of about 2.68 per person referred.
The year-long programme achieved greater weight loss for longer, so led to even bigger reductions in illnesses. The extra costs of the year-long programme were not offset by savings on NHS treatment costs (the additional treatment cost was estimated at 49 per person), but it was still very cost-effective by NICE standards. The benefits may even be underestimated because our model did not include potential savings in social care and indirect healthcare costs.
While modelled data does not provide the same level of evidence as the findings from the randomised controlled trial, it does add to previous evidence that these programmes are a cost-effective treatment option.
So what barriers might prevent greater investment in them? Community weight loss programmes are commissioned by local authorities, but our data shows the benefit as being a reduction in NHS treatment costs (that is, a different department), and only in the long term. The focus on savings in NHS treatment costs may distract from the wider social and economic benefits of a reduction in obesity, which are not captured in current cost-effectiveness models.
With constrained budgets and short parliaments, local authorities may struggle to take the necessary long-term perspective and may focus on what they can afford now. While this is understandable, it may mean we miss a vital opportunity to provide effective treatment options to millions of people who need them.
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Community weight loss programmes should be more widely ... - The Conversation UK