title: Outcomes of a community-based weight management programme for morbidly obese populations.
abstract: Morbid obesity is an ongoing concern worldwide. There is a paucity of research reporting primary care outcomes focussed on complex and morbidly obese populations. The National Institute for Health and Care Excellence (NICE) recommends a specialist, multidisciplinary weight management team for the successful management of such populations. This is the first service evaluation reporting both primary (weight change) and secondary [body mass index (BMI), waist circumference, physical activity levels, fruit and vegetable intake, Rosenberg self-esteem score] outcomes in these patients.
  
  
  
  The present study comprised a prospective observational study of a cohort data set for patients (n = 288) attending their 3-month and 6-month (n = 115) assessment appointments at a specialist community weight management programme.
  
  
  
  Patients had a mean (SD) initial BMI of 45.5 (6.6) kg m-²; 66% were females. Over 80% of patients attending the service lost some weight by 3 months. Average absolute weight loss was 4.11 (4.95) kg at 3 months and 6.30 (8.41) kg at 6 months, equating to 3.28% (3.82%) and 4.90% (6.26%), respectively, demonstrating a statistically significant weight change at both time points (P < 0.001). This meets NICE best practice guidelines for the commissioning of services leading to a minimum of 3% average weight loss, with at least 30% of patients losing at ≥5% of their initial weight. Waist measurement and BMI were reduced significantly at 3 months. Improvements were also seen in physical activity levels, fruit and vegetable consumption, and self-esteem levels (P < 0.001).
  
  
  
  This service was successful in aiding weight loss in morbidly obese populations. The findings of the present study support the view that weight-loss targets of 3% are realistic.
authors.affiliation: Sheffield Business School, Sheffield Hallam University, Sheffield, UK.
authors.forename: L
authors.initials: L
authors.lastname: Nield
authors.affiliation: Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK.
authors.forename: S
authors.initials: S
authors.lastname: Kelly
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003153:Community Health Services / Q000379:methods*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology / Q000628:therapy*; D063868:Patient Outcome Assessment; D015397:Program Evaluation; D011446:Prospective Studies; D012649:Self Concept; D055105:Waist Circumference; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*; D055815:Young Adult
keywords: morbid obesity; service evaluation; weight management