scholarly journals The experiences of postnatal women and healthcare professionals of a brief weight management intervention embedded within the national child immunisation programme

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Natalie Tyldesley-Marshall ◽  
Sheila M Greenfield ◽  
Helen M Parretti ◽  
Kate Jolly ◽  
Susan Jebb ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Healthcare Professionals ◽  
Intervention Group ◽  
Immunisation Programme ◽  
Later Life ◽  
Postnatal Period ◽  
Maternal Weight ◽  
Management Interventions ◽  
Postnatal Women

Abstract Background After childbirth, most women do not lose the extra weight gained during pregnancy. This is important because postnatal weight retention contributes to the development of obesity in later life. Research shows that postnatal women living with overweight would prefer to weigh less, are interested in implementing weight loss strategies, and would like support. Without evidence for the benefit of weight management interventions during pregnancy, postnatal interventions are increasingly important. Research has focused on intensive weight loss programmes, which cannot be offered to all postnatal women. Instead, we investigated the feasibility of a brief intervention delivered to postnatal women at child immunisation appointments. This qualitative study explored the views of women who received the intervention and healthcare professionals who delivered it. Methods The intervention was delivered within the context of the national child immunisation programme. The intervention group were offered brief support encouraging self-management of weight when attending general practices to have their child immunised at two, three and four months of age. The intervention involved motivation and support from practice nurses to encourage women to make healthier lifestyle choices through self-monitoring of weight and signposting to an online weight management programme. Nurses provided external accountability for weight loss. Women were asked to weigh themselves weekly and record this on a weight record card. Nested within this trial, semi-structured interviews explored the experiences of postnatal women who received the intervention and nurses who delivered it. Results The intervention was generally acceptable to participants and child immunisation appointments considered a suitable intervention setting. Nurses were hesitant to discuss maternal weight, viewing the postnatal period as a vulnerable time. Whilst some caveats to implementation were discussed by nurses, they felt the intervention was easy to deliver and would motivate postnatal women to lose weight. Conclusions Participants were keen to lose weight after childbirth. Overall, they reported that the intervention was acceptable, convenient, and, appreciated support to lose weight after childbirth. Although nurses, expressed concerns about raising the topic of weight in the early postnatal period, they felt the intervention was easy to deliver and would help to motivate women to lose weight.

scholarly journals SUN-543 Real World Evidence of Successful Weight Management for the Obese Population: Complete Reversal of Obesity Related Metabolic Co-Morbidities and Weight Loss in Patients Attending a Multidisciplinary Weight Management Clinic in Australia

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zoe Rock ◽  
Juliana Chen ◽  
Joanna Jaques ◽  
Bernard L Champion ◽  
Reginald V Lord ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Exercise Physiology ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Management Interventions ◽  
Co Morbidity ◽  
Total Body ◽  
Total Body Weight Loss

Abstract Over 2.5 billion people worldwide are overweight or obese. Multidisciplinary weight management interventions have evolved to address the complexity of weight loss for those with one or more chronic diseases, and the trend of weight regain. The aim of these interventions is to encourage sustainable lifestyle changes, resulting in weight loss and weight maintenance and improvements in comorbidities. While some prospective clinical trials have demonstrated efficacy, results are often not reported by real life practices. The aim of this study was to evaluate the effectiveness of a Sydney based multidisciplinary weight management clinic with endocrinology, dietetics, exercise physiology, psychology, and bariatric surgical domains. All patients who attended the clinic for weight loss purposes between March 2017 and April 2019 were included (n=220). A retrospective chart review was conducted. Patient data on weight, BMI, waist circumference, body composition measurements, and selected blood test results and co-morbidities were analysed. All patient therapy included endocrinological input for co-morbidity identification and management, lifestyle intervention (dietetic and exercise physiology input) with optional adjunct pharmacotherapy or psychological counselling. Of the 220 cohort, 20 of the patients had sleeve gastrectomy. Patient retention in the clinic after the first consultation was 85% (n=186), a high rate within the weight management community. 59% of patients achieved a minimum of 5% total body weight loss, including 18% who achieved greater than 10% total body weight loss. Additionally, 31% of patients lost enough weight to decrease their BMI class by up to 2 or more classes. Of the gastric sleeve cohort average excess body weight loss was 32kg (21-56kg) enhanced by multidisciplinary care in the lead up to surgery. Across the cohort some patients completely reversed co-morbidities; including dyslipidaemia (n=1), hypertension (n=3), NAFLD (n=1), pre-diabetes (n=8) and type 2 diabetes (n=3), OSA (n=1). These results demonstrate that obesity is a chronic condition that can be successfully managed. We have demonstrated significant durable weight loss and improvement in metabolic co-morbidities with holistic coordinated care. Future directions include translating this model of care into standard practice in Australia and other countries where obesity to date not received the same coordinated approach as other chronic conditions.

scholarly journals Attitudes and Approaches to Use of Meal Replacement Products among Healthcare Professionals in Management of Excess Weight

2020 ◽  
Vol 10 (9) ◽  
pp. 136
Author(s):  
Gabrielle Maston ◽  
Janet Franklin ◽  
Alice A. Gibson ◽  
Elisa Manson ◽  
Samantha Hocking ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Overweight And Obesity ◽  
Prescribing Patterns ◽  
Formal Training ◽  
Meal Replacement ◽  
Potential Barriers ◽  
Safety Concerns

Meal replacement product-based diets are an effective weight loss intervention used in the management of obesity. Historically, these diets have been underutilised by HealthCare Professionals (HCPs). An online survey of mixed methods design was distributed to HCPs to capture current perceptions and prescribing patterns of meal replacement products (MRPs) in the management of overweight and obesity. A total of 303 HCPs working in weight management across Australia began the survey and 197 (65%) completed it. While over 70% of HCPs have prescribed MRP currently or in the past, MRPs are only prescribed to a median 7% of patients seeking weight management treatment. Qualitative analysis identified potential barriers to MRP prescription, which include experience with patient non-compliance, perceived poor long-term weight loss durability and safety concerns regarding the product and its use as a total meal replacement program. Safety concerns are centred on the perceived risk of weight cycling and its potential negative psychological impact. MRP prescription is 66% more likely to occur if HCPs had formal training in the use of MRPs relative to those who did not, with a relative risk (RR) of 1.7 (95% CI 1.4, 2.0). This study highlights the potential barriers to the prescription of MRPs, which are centred around safety concerns. This also indicates that formal training may enhance the likelihood of prescribing MRPs, suggesting that once HCPs have a comprehensive understanding of the products and the evidence behind their use, their prescription is likely to be increased.

scholarly journals Do weight management interventions delivered by online social networks effectively improve body weight, body composition, and chronic disease risk factors? A systematic review

2016 ◽  
Vol 23 (2) ◽  
pp. 263-272 ◽  
Author(s):  
Erik A Willis ◽  
Amanda N Szabo-Reed ◽  
Lauren T Ptomey ◽  
Felicia L Steger ◽  
Jeffery J Honas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Networks ◽  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Online Social Networks ◽  
Disease Risk ◽  
Primary Source ◽  
Outcome Data ◽  
Management Interventions

Introduction Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990–November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results One-hundred percent of the studies ( n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion Using OSN for weight management is in its early stages of development and, while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.

scholarly journals Healthy Dads, Healthy Kids UK, a weight management programme for fathers: feasibility RCT

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033534 ◽  
Author(s):  
Tania Griffin ◽  
Yongzhong Sun ◽  
Manbinder Sidhu ◽  
Peymane Adab ◽  
Adrienne Burgess ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Controlled Trial ◽  
Intervention Group ◽  
Management Programme ◽  
Feasibility Trial ◽  
Minority Ethnic Group ◽  
Weight Management Programme ◽  
Overweight Or Obesity

ObjectiveTo assess (1) the feasibility of delivering a culturally adapted weight management programme, Healthy Dads, Healthy Kids United Kingdom (HDHK-UK), for fathers with overweight or obesity and their primary school-aged children, and (2) the feasibility of conducting a definitive randomised controlled trial (RCT).DesignA two-arm, randomised feasibility trial with a mixed-methods process evaluation.SettingSocioeconomically disadvantaged, ethnically diverse localities in West Midlands, UK.ParticipantsFathers with overweight or obesity and their children aged 4–11 years.InterventionParticipants were randomised in a 1:2 ratio to control (family voucher for a leisure centre) or intervention comprising 9 weekly healthy lifestyle group sessions.OutcomesFeasibility of the intervention and RCT was assessed according to prespecified progression criteria: study recruitment, consent and follow-up, ability to deliver intervention, intervention fidelity, adherence and acceptability, weight loss, using questionnaires and measurements at baseline, 3 and 6 months, and through qualitative interviews.ResultsThe study recruited 43 men, 48% of the target sample size; the mean body mass index was 30.2 kg/m2 (SD 5.1); 61% were from a minority ethnic group; and 54% were from communities in the most disadvantaged quintile for socioeconomic deprivation. Recruitment was challenging. Retention at follow-up of 3 and 6 months was 63%. Identifying delivery sites and appropriately skilled and trained programme facilitators proved difficult. Four programmes were delivered in leisure centres and community venues. Of the 29 intervention participants, 20 (69%) attended the intervention at least once, of whom 75% attended ≥5 sessions. Sessions were delivered with high fidelity. Participants rated sessions as ‘good/very good’ and reported lifestyle behavioural change. Weight loss at 6 months in the intervention group (n=17) was 2.9 kg (95% CI −5.1 to −0.6).ConclusionsThe intervention was well received, but there were significant challenges in recruitment, programme delivery and follow-up. The HDHK-UK study was not considered feasible for progression to a full RCT based on prespecified stop–go criteria.Trial registration numberISRCTN16724454.

scholarly journals GP-delivered brief weight loss interventions: a cohort study of patient responses and subsequent actions, using conversation analysis in UK primary care

2018 ◽  
Vol 68 (674) ◽  
pp. e646-e653 ◽  
Author(s):  
Charlotte Albury ◽  
Elizabeth Stokoe ◽  
Sue Ziebland ◽  
Helena Webb ◽  
Paul Aveyard
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Cohort Study ◽  
Conversation Analysis ◽  
Weight Management ◽  
Management Service ◽  
Management Interventions ◽  
Weight Management Programme ◽  
Patient Responses ◽  
Weight Loss Interventions

BackgroundGuidelines encourage GPs to make brief opportunistic interventions to support weight loss. However, GPs fear that starting these discussions will lead to lengthy consultations. Recognising that patients are committed to take action could allow GPs to shorten brief interventions.AimTo examine which patient responses indicated commitment to action, and the time saved if these had been recognised and the consultation closed sooner.Design and settingA mixed-method cohort study of UK primary care patients participating in a trial of opportunistic weight management interventions.MethodConversation analysis was applied to 226 consultation audiorecordings to identify types of responses from patients that indicated that an offer of referral to weight management was well received. Odds ratios (OR) were calculated to examine associations between response types and likelihood of weight management programme attendance.ResultsAffirmative responses, for example ‘yes’, displayed no conversational evidence that the referral was well received and showed no association with attendance: ‘yes’ (OR 1.2, 95% confidence interval [CI] = 0.37 to 3.95, P = 0.97). However, ‘oh’-prefaced responses and marked positive responses, for example ‘lovely’, showed conversational evidence of enthusiasm and were associated with higher odds of commercial weight management service attendance. Recognising these could have saved doctors a mean of 31 seconds per consultation.ConclusionWhen doctors make brief opportunistic interventions that incorporate the offer of help, ‘oh’-prefaced or marked positive responses indicate enthusiastic acceptance of the offer and a higher likelihood of take-up. Recognising these responses and moving swiftly to facilitate patient action would shorten the brief intervention in many cases.

scholarly journals Impact of adult weight management interventions on mental health: a systematic review and meta-analysis protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031857
Author(s):  
Rebecca A Jones ◽  
Emma R Lawlor ◽  
Simon J Griffin ◽  
Esther M F van Sluijs ◽  
Amy L Ahern
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Weight Loss ◽  
Weight Management ◽  
English Language ◽  
Meta Analysis ◽  
Overweight And Obesity ◽  
Primary Data ◽  
Management Interventions ◽  
The Impact

IntroductionThe effects of interventions targeting weight loss on physical health are well described, yet the evidence for mental health is less clear. It is essential to better understand the impact of weight management interventions on mental health to optimise care and minimise risk of harm. We will assess the effect of behavioural weight management interventions on mental health in adults with overweight and obesity.Methods and analysisThe systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. We will include behavioural weight management interventions with a diet and/or physical activity component focusing on weight loss for adults with a body mass index ≥25 kg/m2. Randomised controlled trials (RCTs) and cluster RCTs will be the only eligible study designs. Outcomes of interest will be related to mental health. The following databases were searched from inception to 07 May 2019: MEDLINE, Embase, Cochrane database (CENTRAL), PsycINFO, ASSIA, AMED and CINAHL. The search strategy was based on four concepts: (1) adults, defined as ≥18 years, with overweight/obesity, defined as BMI ≥25kg/m², (2) weight management interventions, (3) mental health outcomes and (4) study design. The search was restricted to English-language published papers, with no other restrictions applied. Two stage screening for eligibility will be completed by two independent reviewers, with two independent reviewers completing data extraction and risk of bias assessment. Data permitting, a random-effects meta-analysis of outcomes, subgroup analyses and meta-regression will be conducted. If not appropriate, narrative synthesis and ‘levels of evidence’ assessment will be completed.Ethics and disseminationEthical approval is not required as primary data will not be collected. The completed systematic review will be disseminated in a peer-reviewed journal, at conferences and contribute towards the lead author’s PhD thesis.PROSPERO registration numberCRD42019131659.

Impact of a Weight Management Intervention on Eating Competence: Importance of Measurement Interval in Protocol Design

2017 ◽  
Vol 32 (3) ◽  
pp. 718-728 ◽  
Author(s):  
Barbara Lohse ◽  
Jodi Stotts Krall ◽  
Tricia Psota ◽  
Penny Kris-Etherton
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Repeated Measures ◽  
Cognitive Theory ◽  
Eating Attitudes ◽  
Exercise Session ◽  
Measurement Interval ◽  
Management Interventions ◽  
Supervised Exercise ◽  
Eating Competence

Purpose: To examine changes in eating competence (EC) in 12-month weight loss intervention. Design: Randomized, parallel-arm with weight loss phase (baseline to month 4) and weight-maintenance phase (months 4-12). Setting: Face-to-face in University classrooms, supervised and self-directed fitness sessions at University fitness center, and home. Participants: Premenopausal, mostly college-educated Pennsylvania women, body mass index >25 (n = 101). Intervention: Twenty-eight, 1-hour classes tailored for extremes of the Dietary Guidelines’ fat recommendations, based on social cognitive theory, problem-based learning delivery over 12 months. Exercise component included supervised and self-directed stretching, aerobics, and strength training. Measures: Anthropometrics, lipid profile, blood pressure, 24-hour dietary recalls, cognitive behavioral measures, Satter Eating Competence Inventory (ecSI). Analysis: General linear model repeated measures analysis of variance for outcome variables. Results: A total of 40% (n = 40) completed the ecSI. Overall, education and supervised exercise session attendance were 77% and 88%, respectively. Similar weight loss for lower and moderate fat groups (6.7 kg and 5.4 kg). The EC was unchanged baseline to month 4 but increased significantly from months 4 to 12, baseline to month 12 for both groups. The EC change baseline to month 12 was inversely associated with weight change from baseline to months 4 and 12. Conclusion: Weight management interventions, likely to introduce concerns with eating attitudes, behaviors, and foods, can reduce EC. Short-term measurement of EC change captures these consequent adjustments without opportunity to regain self-efficacy. Extending the measurement interval better reflects intervention impact on EC.

scholarly journals A Systematic Review of Methods to Predict Weight Trajectories in Health Economic Models of Behavioral Weight-Management Programs: The Potential Role of Psychosocial Factors

2019 ◽  
Vol 40 (1) ◽  
pp. 90-105
Author(s):  
Sarah Bates ◽  
Thomas Bayley ◽  
Paul Norman ◽  
Penny Breeze ◽  
Alan Brennan
Keyword(s):  
Health Economic ◽  
Weight Loss ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Weight Management ◽  
Psychosocial Factors ◽  
Economic Models ◽  
Psychosocial Variables ◽  
Management Interventions ◽  
Weight Trajectories

Objectives. There is limited evidence on the long-term effectiveness of behavioral weight-management interventions, and thus, when conducting health economic modeling, assumptions are made about weight trajectories. The aims of this review were to examine these assumptions made about weight trajectories, the evidence sources used to justify them, and the impact of assumptions on estimated cost-effectiveness. Given the evidence that some psychosocial variables are associated with weight-loss trajectories, we also aimed to examine the extent to which psychosocial variables have been used to estimate weight trajectories and whether psychosocial variables were measured within cited evidence sources. Methods. A search of databases (Medline, PubMed, Cochrane, NHS Economic Evaluation, Embase, PSYCinfo, CINAHL, EconLit) was conducted using keywords related to overweight, weight-management, and economic evaluation. Economic evaluations of weight-management interventions that included modeling beyond trial data were included. Results. Within the 38 eligible articles, 6 types of assumptions were reported (weight loss maintained, weight loss regained immediately, linear weight regain, subgroup-specific trajectories, exponential decay of effect, maintenance followed by regain). Fifteen articles cited at least 1 evidence source to support the assumption reported. The assumption used affected the assessment of cost-effectiveness in 9 of the 19 studies that tested this in sensitivity analyses. None of the articles reported using psychosocial factors to estimate weight trajectories. However, psychosocial factors were measured in evidence sources cited by 11 health economic models. Conclusions. Given the range of weight trajectories reported and the potential impact on funding decisions, further research is warranted to investigate how psychosocial variables measured in trials can be used within health economic models to simulate heterogeneous weight trajectories and potentially improve the accuracy of cost-effectiveness estimates.

scholarly journals Are Interventions Delivered by Healthcare Professionals Effective for Weight Management? A Systematic Review of Systematic Reviews

2021 ◽  
pp. 1-38
Author(s):  
Tracy Epton ◽  
Christopher Keyworth ◽  
Joanna Goldthorpe ◽  
Rachel Calam ◽  
Christopher J. Armitage
Keyword(s):  
Weight Management ◽  
Systematic Reviews ◽  
Healthcare Professionals ◽  
Healthy Weight ◽  
Randomized Controlled ◽  
Management Interventions ◽  
Moderating Factors ◽  
Level Data ◽  
Secondary Analyses ◽  
Sample Characteristics

Abstract Objective: There are many systematic reviews of weight-management interventions delivered by healthcare professionals, but it is not clear under what circumstances interventions are effective due to differences in review methodology. This review of systematic-reviews synthesises the evidence about: (a) the effectiveness of healthcare-professional delivered weight-management interventions, and (b) intervention and sample characteristics related to their effectiveness. Design: The review of review involved searching six databases (inception - October 2020). Reviews were included if they were (a) systematic; (b) weight-management interventions delivered, at least partially, by healthcare-professionals; (c) of randomized controlled trials; and (d) written in English. Data regarding weight-management outcomes (e.g., weight) and moderating-factors were extracted. Secondary analyses were conducted using study-level data reported in each of the reviews. Participants: not applicable. Results: Six systematic-reviews were included (46 unique studies). First-level synthesis showed that weight-management interventions delivered by healthcare professionals are effective. The second-level synthesis found that interventions are only successful for up to 6 months, are most effective for women, non-Caucasians and adults and are most effective if they have at least 6 sessions Conclusions: As interventions are only successful for up to 6 months they are not sufficient for achieving and maintaining a healthy weight.

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