Evaluation of the Counterweight Programme for obesity management in primary care: a starting point for continuous improvement

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Abstract
Evaluation for obesity management in primary care is limited, and successful outcomes are from intensive clinical trials in hospital settings. To determine to what extent measures of success seen in intensive clinical trials can be achieved in routine primary care. Primary outcome measures were weight change and percentage of patients achieving >or=5% loss at 12 and 24 months. Prospective evaluation of a new continuous improvement model for weight management in primary care. Primary care, UK. Primary care practice nurses from 65 UK general practices delivered interventions to 1906 patients with body mass index (BMI)>or=30 kg/m2 or>or=28 kg/m2 with obesity-related comorbidities. Mean baseline weight was 101.2 kg (BMI 37.1 kg/m2); 25% of patients had BMI>or=40 kg/m2 and 74% had >or=1 major obesity-related comorbidity. At final data capture 1419 patients were in the programme for >or=12 months, and 825 for >or=24 months. Mean weight change in those who attended and had data at 12 months (n=642) was -3.0 kg (95% CI=-3.5 to -2.4 kg) and at 24 months (n=357) was -2.3 kg (95% CI=-3.2 to -1.4 kg). Among attenders at specific time-points, 30.7% had maintained weight loss of >or=5% at 12 months, and 31.9% at 24 months. A total of 761 (54%) of all 1419 patients who had been enrolled in the programme for >12 months provided data at or beyond 12 months. This intervention achieves and maintains clinically valuable weight loss within routine primary care.