Oral Presentation Australian & New Zealand Obesity Society 2015 Annual Scientific Meeting

An investigation into factors associated with weight loss: implications for policy for referrals to funded weight management programmes (#10)

Claire D Madigan 1 , Amanda J Daley 2 , Kate Jolly 3
  1. University of Sydney, The Boden Institute, Camperdown, NSW, Australia
  2. Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK
  3. Institute of Applied Health Research, University of Birmingham, Birmingham, UK

Introduction: In the UK as part of the care pathway for obesity, behavioural weight management programmes are recommended. These are funded by Public Health budgets, which are under considerable financial strain. Finding the most effective referral policies would have important public health implications. Here we compare participants who self-referred versus GP referral; a BMI ≥40 kg/m2 against lower BMIs and multiple referrals to a programme. 

Methods: A prospective cohort study of 15,621 participants who were referred to one of three, 12-week behavioural weight loss programmes in Birmingham, UK. Linear regression of percentage weight change was used, taking into account covariates to examine the mean difference in weight change. The primary analyses were conducted using intention to treat.

Results: Participant’s mean age was 48.5 years, 78.7% were white, 90.3% female and mean BMI at baseline was 36.3 kg/m2. On average those who self-referred lost -3.1 % (SD 3.7) and there were no statistically significant differences between those that self-referred and those that were referred by their GP. Those with a BMI ≥40 kg/m2 lost statistically significantly more -0.31% (95%CI -0.51 to -0.15) than those with a BMI <40 kg/m2. Descriptive statistics showed that participants who attended a programme once lost 3.5 kg (SD 4.0), those who had two referrals lost 2.5 kg (SD 3.5) and those who had three or more referrals lost 2.1 kg (3.4). Inference statistics are being undertaken and will be available for the conference. 

Conclusion: Participants who self-refer or those referred by GPs have similar weight losses and both methods can be used for weight management services. These programmes are suitable for those with a BMI ≥40 kg/m2. Preliminary evidence suggests that second and third referrals result in less weight loss and needs to be considered for commissioning policies.