title: Empowering primary care to tackle the obesity epidemic: the Counterweight Programme.
abstract: OBJECTIVE
  To improve the management of obese adults (18-75 y) in primary care.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  UK primary care.
  
  
  METHODS
  Obese patients (body mass index > or =30 kg/m(2)) or BMI> or =28 kg/m(2) with obesity-related comorbidities in 80 general practices.
  
  
  METHODS
  The model consists of four phases: (1) audit and project development, (2) practice training and support, (3) nurse-led patient intervention, and (4) evaluation. The intervention programme used evidence-based pathways, which included strategies to empower clinicians and patients. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation.
  
  
  METHODS
  Proportion of practices trained and recruiting patients, and weight change at 12 months.
  
  
  RESULTS
  By March 2004, 58 of the 62 (93.5%) intervention practices had been trained, 47 (75.8%) practices were active in implementing the model and 1549 patients had been recruited. At 12 months, 33% of patients achieved a clinically meaningful weight loss of 5% or more. A total of 49% of patients were classed as 'completers' in that they attended the requisite number of appointments in 3, 6 and 12 months. 'Completers' achieved more successful weight loss with 40% achieving a weight loss of 5% or more at 12 months.
  
  
  CONCLUSIONS
  The Counterweight programme provides a promising model to improve the management of obesity in primary care.
authors.affiliation: Diabetes Centre, Royal United Hospital, Bath, UK.
authors.forename: M
authors.initials: M
authors.lastname: McQuigg
authors.forename: J
authors.initials: J
authors.lastname: Brown
authors.forename: J
authors.initials: J
authors.lastname: Broom
authors.forename: R A
authors.initials: RA
authors.lastname: Laws
authors.forename: J P D
authors.initials: JP
authors.lastname: Reckless
authors.forename: P A
authors.initials: PA
authors.lastname: Noble
authors.forename: S
authors.initials: S
authors.lastname: Kumar
authors.forename: E L
authors.initials: EL
authors.lastname: McCombie
authors.forename: M E J
authors.initials: ME
authors.lastname: Lean
authors.forename: G F
authors.initials: GF
authors.lastname: Lyons
authors.forename: G S
authors.initials: GS
authors.lastname: Frost
authors.forename: M F
authors.initials: MF
authors.lastname: Quinn
authors.forename: J H
authors.initials: JH
authors.lastname: Barth
authors.forename: S M
authors.initials: SM
authors.lastname: Haynes
authors.forename: N
authors.initials: N
authors.lastname: Finer
authors.forename: H M
authors.initials: HM
authors.lastname: Ross
authors.forename: D J
authors.initials: DJ
authors.lastname: Hole
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D015331:Cohort Studies; D019317:Evidence-Based Medicine; D015444:Exercise / Q000502:physiology; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D052756:Nutritional Sciences / Q000193:education*; D009765:Obesity / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D010349:Patient Compliance; D010353:Patient Education as Topic; D010821:Physicians, Family; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D020377:Self Efficacy; D016896:Treatment Outcome; D006113:United Kingdom