title: An evaluation of a multi-component adult weight management on referral intervention in a community setting.
abstract: BACKGROUND
  National Institute for Health and Care Excellence (NICE) guidance on adult weight management recommends interventions are multi-component. We aimed to assess the implementation and health benefits of a primary care referral to an adult multi-component weight management intervention in a community setting. The intervention was offered through Primary care in National Health Service (NHS) South Gloucestershire, UK, from Oct 2008 to Nov 2010, in partnership with statutory, community and commercial providers. The scheme offered 12 weeks' community based concurrent support of dietary (Weight Watchers, WW), physical activity (Exercise on Prescription, EOP) and behavioural change (motivational interviewing) components to obese adults. Funding was available for 600 places.
  
  
  RESULTS
  Five hundred and fifty nine participants engaged with the intervention, mean age 48 years, 88% female. Mean weight loss for all engagers was 3.7 kg (95 % confidence interval 3.4, 4.1). Participants completing the intervention achieved the largest weight reduction (mean loss 5.9 kg; 5.3, 6.6). Achievement of 5% weight loss was higher in completers (58%; 50, 65) compared to non-completers (19%; 12, 26) and people who only participated in one commercial component of the intervention (either WW or EOP; 19%; 13, 24).
  
  
  CONCLUSIONS
  A multi-component weight management programme may be beneficial for weight loss, but a randomized controlled trial is needed to establish effectiveness and to evaluate cost.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK. Kate.Birnie@bristol.ac.uk.
authors.forename: Kate
authors.initials: K
authors.lastname: Birnie
authors.affiliation: NHS South Gloucestershire, Bristol, UK. Lindsey.Thomas@southglos.gov.uk.|South Gloucestershire Council, Bristol, UK. Lindsey.Thomas@southglos.gov.uk.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Thomas
authors.affiliation: South Gloucestershire Council, Bristol, UK. clare.fleming@southglos.gov.uk.
authors.forename: Clare
authors.initials: C
authors.lastname: Fleming
authors.affiliation: NHS South Gloucestershire, Bristol, UK. SarahW.Phillips@southglos.gov.uk.|South Gloucestershire Council, Bristol, UK. SarahW.Phillips@southglos.gov.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Phillips
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK. Jonathan.Sterne@bristol.ac.uk.
authors.forename: Jonathan A C
authors.initials: JA
authors.lastname: Sterne
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK. Jenny.Donovan@bristol.ac.uk.
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Donovan
authors.affiliation: NHS South Gloucestershire, Bristol, UK. juliesacraig@outlook.com.|South Gloucestershire Council, Bristol, UK. juliesacraig@outlook.com.
authors.forename: Julie
authors.initials: J
authors.lastname: Craig
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003153:Community Health Services / Q000458:organization & administration; D004038:Diet, Reducing / Q000379:methods*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology / Q000628:therapy*; D011320:Primary Health Care / Q000458:organization & administration; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration*; D006113:United Kingdom; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000458:organization & administration*