title: Description and preliminary results from a structured specialist behavioural weight management group intervention: Specialist Lifestyle Management (SLiM) programme.
abstract: BACKGROUND
  Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented.
  
  
  METHODS
  The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35 kg/m(2) with comorbidity or ≥40 kg/m(2) without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data.
  
  
  RESULTS
  Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m(2)) with 87.2% of patients having a BMI≥40 kg/m(2) and 12.4% with BMI≥60 kg/m(2). The mean weight change of all patients enrolled was -4.1 kg (95% CI -3.6 to -4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving -5.5 kg (95% CI -4.2 to -6.2 kg, p=0.0001) and non-completers achieving -2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss.
  
  
  CONCLUSIONS
  The SLiM programme is an effective group intervention for the management of severe and complex obesity.
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK Department of Diabetes, Endocrinology and Metabolism, Faculty of Medicine, Imperial College, London, UK.
authors: Adrian
authors: A
authors: Brown
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK.
authors: Amy
authors: A
authors: Gouldstone
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK.
authors: Emily
authors: E
authors: Fox
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK.
authors: Annmarie
authors: A
authors: Field
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK.
authors: Wendy
authors: W
authors: Todd
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK.
authors: Jayadave
authors: J
authors: Shakher
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK School of Life and Health Sciences, Aston University, Birmingham, UK.
authors: Srikanth
authors: S
authors: Bellary
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK.
authors: Ming Ming
authors: MM
authors: Teh
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK.
authors: Muhammad
authors: M
authors: Azam
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK.
authors: Reggie
authors: R
authors: John
authors: Theme 8 (Diabetes), Birmingham and Black Country NIHR CLAHRC, University of Birmingham, Birmingham, UK.
authors: Alison
authors: A
authors: Jagielski
authors: Department of Medicine, Weill Cornell Medical College, Doha, Qatar.
authors: Teresa
authors: T
authors: Arora
authors: Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK Mannheim Medical Faculty, Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany.
authors: G Neil
authors: GN
authors: Thomas
authors: Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, UK Theme 8 (Diabetes), Birmingham and Black Country NIHR CLAHRC, University of Birmingham, Birmingham, UK Department of Medicine, Weill Cornell Medical College, Doha, Qatar Department of Medicine, Kings College London, London, UK Department of Diabetes and Specialist Weight Management Service, Hamad Medical Corporation, Doha, Qatar.
authors: Shahrad
authors: S
authors: Taheri
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015331:Cohort Studies; D005247:Feeding Behavior; D005260:Female; D049690:History, Ancient; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000628:therapy*; D010353:Patient Education as Topic / Q000379:methods*; D011615:Psychotherapy, Group; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome; D061217:Weight Reduction Programs
keywords: EPIDEMIOLOGY; NUTRITION & DIETETICS