Empowering primary care to tackle the obesity epidemic: the Counterweight Programme.
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.
McQuigg
M
M
Diabetes Centre, Royal United Hospital, Bath, UK.
Brown
J
J
Broom
J
J
Laws
R A
RA
Reckless
J P D
JP
Noble
P A
PA
Kumar
S
S
McCombie
E L
EL
Lean
M E J
ME
Lyons
G F
GF
Frost
G S
GS
Quinn
M F
MF
Barth
J H
JH
Haynes
S M
SM
Finer
N
N
Ross
H M
HM
Hole
D J
DJ
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