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Effective UK weight management services for adults
Author(s) -
McCombie L.,
Lean M. E. J.,
Haslam D.
Publication year - 2012
Publication title -
clinical obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 12
eISSN - 1758-8111
pISSN - 1758-8103
DOI - 10.1111/j.1758-8111.2012.00049.x
Subject(s) - medicine , psychological intervention , referral , weight management , context (archaeology) , body mass index , population , obesity , weight loss , intervention (counseling) , service (business) , family medicine , gerontology , nursing , environmental health , paleontology , pathology , biology , economy , economics
Summary A number of evidence‐based weight management interventions are now available with different models and serving different patient/client groups. While positive outcomes are a key to the decision‐making process, so too is the information around how these outcomes were achieved, in what population, how transferable the outcomes would be to the population a service would be aiming to cover and at what cost to the service provider and or the individual. This paper examines all the UK interventions with recent peer‐reviewed evidence of their effectiveness in ‘realistic’ settings and cost‐effectiveness, in the context of N ational I nstitute of H ealth and C linical E xcellence ( NICE) and S cottish I ntercollegiate G uideline N etwork ( SIGN) guidelines. It concludes that the evidence‐based approaches allow intervention at different stages in the disease process of obesity, which are effective in different settings. Self‐referral to commercial agencies, by individuals with relatively low body mass index ( BMI) and few medical complications, is a reasonable first step. For more severely obese individuals (e.g. BMI > 35 kg m −2 ) requiring more medically complicated care, evidence is largely lacking for these services, but the community‐based C ounterweight P rogramme is effective and cost‐effective in maintaining weight loss >5 kg up to 2 years for 30–40% of attenders. For more complicated and resistant obesity, referral to a secondary care‐based service can generate short‐term weight loss, but 12‐month data are unavailable.