Evaluation of a multidisciplinary Tier 3 weight management service for adults with morbid obesity, or obesity and comorbidities, based in primary care
Article first published online: 1 JUL 2014
© 2014 The Authors. Clinical Obesity published by John Wiley & Sons Ltd on behalf of World Obesity.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Volume 4, Issue 5, pages 254–266, October 2014
How to Cite
Jennings, A., Hughes, C. A., Kumaravel, B., Bachmann, M. O., Steel, N., Capehorn, M. and Cheema, K. (2014), Evaluation of a multidisciplinary Tier 3 weight management service for adults with morbid obesity, or obesity and comorbidities, based in primary care. Clinical Obesity, 4: 254–266. doi: 10.1111/cob.12066
- Issue published online: 8 SEP 2014
- Article first published online: 1 JUL 2014
- Manuscript Accepted: 26 MAY 2014
- Manuscript Revised: 5 MAY 2014
- Manuscript Received: 15 SEP 2013
- NHS East of England innovation fund
- NHS Norfolk PCT
- NNCCG and donations
- primary care;
- Tier 3
A multidisciplinary Tier 3 weight management service in primary care recruited patients with a body mass index ≥40 kg·m−2, or 30 kg·m−2 with obesity-related co-morbidity to a 1-year programme. A cohort of 230 participants was recruited and evaluated using the National Obesity Observatory Standard Evaluation Framework. The primary outcome was weight loss of at least 5% of baseline weight at 12 months. Diet was assessed using the two-item food frequency questionnaire, activity using the General Practice Physical Activity questionnaire and quality of life using the EuroQol-5D-5L questionnaire. A focus group explored the participants' experiences. Baseline mean weight was 124.4 kg and mean body mass index was 44.1 kg·m−2. A total of 102 participants achieved 5% weight loss at 12 months. The mean weight loss was 10.2 kg among the 117 participants who completed the 12-month programme. Baseline observation carried forward analysis gave a mean weight loss of 5.9 kg at 12 months. Fruit and vegetable intake, activity level and quality of life all improved. The dropout rate was 14.3% at 6 months and 45.1% at 1 year. Focus group participants described high levels of satisfaction. It was possible to deliver a Tier 3 weight management service for obese patients with complex co-morbidity in a primary care setting with a full multidisciplinary team, which obtained good health outcomes compared with existing services.