title: Evaluation of the first phase of a specialist weight management programme in the UK National Health Service: prospective cohort study.
abstract: OBJECTIVE
  To evaluate the first phase of a specialist weight management programme provided entirely within the UK National Health Service.
  
  
  METHODS
  Prospective cohort study using multiple logistic regression analysis to report odds of ≥5 kg weight loss in all referrals and completers, and odds of completion, with 95 % confidence intervals. Anxiety and depression 'caseness' were measured by the Hospital Anxiety and Depression Scale.
  
  
  METHODS
  Glasgow and Clyde Weight Management Service (GCWMS) is a specialist multidisciplinary service, with clinical psychology support, for patients with BMI ≥35 kg/m2 or BMI ≥30 kg/m2 with co-morbidities.
  
  
  METHODS
  All patients referred to GCWMS between 2004 and 2006.
  
  
  RESULTS
  Of 2976 patients referred to GCWMS, 2156 (72·4 %) opted into the service and 809 completed phase 1. Among 809 completers, 35·5 % (n 287) lost ≥5 kg. Age ≥40 years, male sex (OR = 1·39, 95 % CI 1·05, 1·82), BMI ≥ 50 kg/m2 (OR = 1·70, 95 % CI 1·14, 2·54) and depression (OR = 1·81, 95 % CI 1·35, 2·44) increased the likelihood of losing ≥5 kg. Diabetes mellitus (OR = 0·55, 95 % CI 0·38, 0·81) and socio-economic deprivation were associated with poorer outcomes. Success in patients aged ≥40 years and with BMI ≥50 kg/m2 was associated with higher completion rates of the programme. Patients from the most deprived areas were less likely to lose ≥5 kg because of non-completion of the programme.
  
  
  CONCLUSIONS
  Further improvements in overall effectiveness might be achieved through targeting improvements in appropriateness of referrals, retention and effective interventions at specific populations of patients.
authors.affiliation: West of Scotland Cancer Surveillance Unit, 1 Lilybank Gardens, Glasgow G12 8RZ, UK. david.morrison@nhs.net
authors.forename: David S
authors.initials: DS
authors.lastname: Morrison
authors.forename: Susan
authors.initials: S
authors.lastname: Boyle
authors.forename: Caroline
authors.initials: C
authors.lastname: Morrison
authors.forename: Gwen
authors.initials: G
authors.lastname: Allardice
authors.forename: Nicola
authors.initials: N
authors.lastname: Greenlaw
authors.forename: Lorna
authors.initials: L
authors.lastname: Forde
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016001:Confidence Intervals; D003863:Depression / Q000150:complications; D003920:Diabetes Mellitus / Q000209:etiology / Q000378:metabolism; D005260:Female; D006761:Hospitals; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009313:National Health Programs; D009765:Obesity / Q000150:complications / Q000628:therapy*; D011446:Prospective Studies; D012017:Referral and Consultation; D012959:Socioeconomic Factors; D006113:United Kingdom; D061217:Weight Reduction Programs