Referral to a commercial weight management programme enhances weight loss achieved in primary care

Transcription

1 Referral to a commercial weight management programme enhances weight loss achieved in primary care Susan A. Jebb, Amy L. Ahern, Ashley D. Olson, Louise M. Aston - MRC Human Nutrition Research Unit, Cambridge, UK Christina Holzapfel, Julia Stoll, Hans Hauner - Technische Universität München, Munich, Germany Annie Simpson, Suzanne Pearson, Nick Fuller, Ian Caterson - University of Sydney, Sydney, Australia Introduction: The scale of weight management services needed in primary care is daunting. This study compared the effectiveness of 12 month referral to a commercial weight loss programme with 12 month standard care by health professionals in three countries: Australia, Germany and the UK. Methods: Participants (N=772; 87% female; median age = 47 years; median start BMI = 31.3 kg/m²) were randomly allocated to receive 12 months standard care in general practice or free vouchers for 12 months attendance at Weight Watchers. Participants weight was recorded at measurement appointments at 0, 2, 4, 6, 9 and 12 months. Results: 59% WW and 50% SC completed the 12 month assessment. Analysis using BOCF showed mean weight loss at 12 months was significantly greater for Weight Watchers (WW) than standard care (SC) (-4.02 kg SEM 0.31 vs kg SEM 0.19; p<0.001). 36% WW and 16% SC lost 5% initial weight. 19% WW and 6% SC lost 10%. Among completers, mean weight loss was significantly greater in WW than SC (-6.87kg SEM 0.43 vs kg SEM 0.34; p<0.001). 61% WW and 32% SC lost 5%. 33% WW and 12% SC lost 10%. Conclusion: Referral to Weight Watchers over 12 months significantly enhanced weight loss achieved through standard care. Meaningful weight loss ( 5%) was achieved by 36% of all WW patients referred and 61% those who completed the 12 month assessment. These findings support the use of Weight Watchers as an option for large scale provision of weight management services in primary care. 1. Conflict of Interest: None

2 Outcomes of providing a scalable weight loss service in Spain Hellman, Z Weight Watchers UK, Maidenhead, England Miller Kovach, K Weight Watchers International, New York, United States of America Introduction: Spain has one of the highest rates of obesity in Europe, yet effective therapeutic and preventative services that can be provided to a large number of people are limited. In recent years, a commercial weight loss company (Weight Watchers ) has expanded into Spain. This abstract explores the outcomes of providing a scalable weight loss service in Spain. Methods: Member records were analysed for the years 2003 and Programme participants numbered 8,158 and 15,774 respectively. Data was collected by group leaders and relayed to a central database. All participant weights were measured in meetings on appropriately calibrated scales. Results: Average starting BMI was 30.9±5.4 both years. Among those records with complete data and at least two sessions attended, average weekly weight loss was 0.4±0.9 kg in 2003 and 0.4±0.5 kg in Average participation was weeks with a total weight loss of 3.3±4.7 kg in 2003 and 3.4±4.1 kg in 2008 (all p<0.001). In the 2009 member satisfaction survey; 84% of current members stated that they were satisfied / highly satisfied with the service, with 96% reporting that it met/exceeded expectations. Conclusion: This data suggests that a comprehensive, group based weight loss service that has been proven effective in other countries may also be appropriate for Spain. It also demonstrates that the method is scalable with no loss of effectiveness despite an almost doubling of participants over a 5 year period. Large scale participation may translate into considerable savings to the government and improvements in health outcomes for individuals. 1. Conflict of Interest: The authors of this abstract are employees of Weight Watchers UK Ltd. and Weight Watchers International.

3 Early Results of a Commercial Weight loss Service in China Miller Kovach, K Weight Watchers International Inc. New York Jin, S Weight Watchers Danone (China) Weight Loss Consultation Company, Shanghai, China Introduction: One in five of the world s obese people are Chinese. The prevalence of excess weight in China happened much faster than in other parts of the globe and China is ill equipped to handle the consequences. Lifestyle intervention was shown in the west to result in weight loss and long term benefits. Commercial lifestyle interventions are new to China and yet to be proven successful. Methods: Weight Watchers Danone (China) Weight Loss Consultation Company began offering an adapted for China Weight Watchers program in Shanghai in August 28th 2008 and Nanjing in July 8th The program is based on the POINTS Weight Loss System and includes a food plan, activity plan, behavior modification and group support. There are 34 weekly meetings offered; meetings are led by trained staff who have successfully lost weight themselves. Results: After 67 weeks, 1968 women and 75 men have participated, average age is 30.4 years; average starting weight is 65.1kg, average initial BMI is Average weekly weight loss is 0.36 kg. 750 lost more than 5% of the initial weight, 902 lost more than 2.5kg and 265 achieved their self selected weight goal (BMI 19 24). More than 85% of the participants state that they are satisfied or highly satisfied with the service. Conclusion: These findings suggest that the Weight Watchers method, a commercial lifestyle program proven effective in western cultures, can be successfully employed for weight loss in a traditional Eastern culture among the mildly overweight population. The potential for impact among the obese needs further exploration.

4 An Audit of the UK Weight Watchers NHS Referral Scheme Amy L. Ahern, Ashley D. Olson, Louise M. Aston and Susan A. Jebb MRC Human Nutrition Research Unit, Fulbourn Road, Cambridge, UK Introduction: In some areas the UK National Health Service (NHS) has formed partnerships with commercial companies to offer weight management services. This study assessed the weight change among patients given free vouchers to attend 12 Weight Watchers (WW) meetings. Methods: Data was obtained from the WW NHS Referral Scheme database for 29,326 referral courses (90% female; median age 49 years [IQR years]; median BMI 35.1 kg/m² [IQR kg/m 2 ]) completed between April 2007 and October Body weights were measured at WW meetings, relayed to the central database and data was analysed by an independent research team. Completion was defined as attending 10 sessions. Results: Analysis of all courses showed median weight loss was 2.8 kg [IQR kg] (3.1% initial weight). 33% of courses resulted in loss of 5% initial weight and 6.8% in 10% loss. 58% of courses were completed. Median weight loss in patients completing a first course was 5.2kg [IQR kg] (5.5% of initial weight). Over half (55%) these patients lost 5% and 12.2% lost 10% initial weight. Conclusion: A third of all patients referred through the WW NHS Referral Scheme achieved clinically significant weight loss ( 5%). This is one of the largest audits of a commercial weight loss programme and results compare favourably with other options for weight loss. Further research should examine the sustainability and cost effectiveness of this approach to weight management in primary care. 1. Conflict of Interest: None

5 Changes in cardiovascular risk factors with participation in a 12 week weight loss trial using a commercial format Milsom, V, Malcolm,R, Cronan, G, Pechon, S, Weight Management Center, Medical University of South Carolina, Charleston, SC Miller Kovach, K, Rost, S, O Neil, PM Weight Watchers International, New York, NY Introduction: Average loss of 5 10% of body weight often improves cardiovascular risk factors. This is usually shown after 6 12 months of exposure to weight loss medications and/or intensive dietary, behavioral and/or exercise instruction. We assessed changes in risk factors after 12 weeks in a weight loss trial featuring a commercial format with limited dietary and exercise instruction. Methods: Subjects (132 adults; BMI=27 35) were randomized to 1 of 2 methods of counting food intake with weekly group meetings using a commercial weight loss program. Lipids, blood glucose, blood pressure and waist circumference were assessed at baseline and Week 12. Results: 112 subjects (100F,12M) completed final assessments. With no weight loss differences between conditions, analyses used the combined sample. M weight loss was 3.74 kg (SD=3.16) and 4.37% of baseline weight (SD=3.71). Significant improvements (p <.05) were seen on triglycerides, total cholesterol and LDL cholesterol. There were trends (p<.10) toward reductions in fasting glucose, systolic blood pressure, and HDL cholesterol. Among subjects with baseline values of the risk factor beyond recommended cut points, significant (p<.05) reductions were seen on triglycerides (N=22), total cholesterol (N=41), LDL cholesterol (N=77), glucose (N=8), systolic and diastolic blood pressure (N=14), and waist circumference (N=88), and a trend (p<.10) toward an increase in HDL (N=57). Conclusion: With modest weight loss over 12 weeks using a commercial format with limited diet instruction, improvements were seen in a number of risk factors, particularly among subjects with initially higher risk values. The duration of these effects remains to be determined. 1. Conflict of Interest: Research support (RM, GC, SP, PO) and employment (KK, SR) by Weight Watchers International 2. Funding: This study was supported by a grant from Weight Watchers International.