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Study finds primary care delivered weight management interventions effective

By Melanie Hinze
Primary care-based behavioural weight management interventions for adults with obesity are not only effective, but could also be offered to the general public, new research published in The BMJ suggests.

The authors of a systematic review and meta­-analysis of randomised controlled trials assessed behavioural weight management interventions for adults with a body mass index of 25 kg/m2 or above delivered in primary care. They compared these with no treatment, attention control or minimal intervention and weight change after at least 12 months’ follow up.

In their review, the authors included 34 trials with a median of 276 participants (range, 50 to 864) conducted in the US, the UK or Spain. The mean BMI at baseline was 35.2 kg/m2 and mean age of participants was 48 years. The interventions comprised between one and several sessions over a median of 12 months, with a median 12­-month follow up.

Absolute weight change was a reduction in weight of 3.7 kg in the intervention group and 1.4 kg in the comparator group. The mean difference between the intervention and comparator groups at 12 months was 2.3 kg in favour of the intervention group. At beyond 24 months, the mean difference in weight change was 1.8 kg, and the mean difference in waist circumference was 2.5 cm, both also favouring the intervention.

‘Weight management interventions delivered in primary care are effective and should be part of services offered to members of the public to help them manage weight,’ the authors wrote.

Associate Professor Karen Murphy, Dietitian and health researcher at the University of South Australia, Adelaide, said the authors showed that weight loss interventions delivered in a range of settings led to similar amounts of weight loss, over about 12 months.

Additionally, ‘The authors showed in the present research that those participants who had 12 or more contacts with study staff during the interventions, lost significantly more weight than those with fewer contacts,’ she said.

Professor Murphy said that continuity in patient care needs to be considered across healthcare systems, to ensure that services were available to assist and support individuals with their healthcare journey. Health professionals should encourage individuals to achieve and maintain a healthy weight through eating from the core food groups, watching portion size and minimising sedentariness.

‘However, this is not a once off visit with a GP or dietitian,’ she said. ‘It should be an ongoing collaboration between the individuals and healthcare professionals, to help individuals achieve their health goals,’ said Professor Murphy.
BMJ 2022; 377: e069719.