Obesity Management Program - Counterweight
Weight Loss Study Aim
To provide an overview of the Counterweight Program
Weight Loss Study Method
The Counterweight Program aims to evaluate the management of obesity in
primary care. 80 practices from 7 areas of the UK were recruited into
the program. Specialist obesity dietitians undertook audit and provided
training, clinical support and evidence based structured protocols for
GPs and nurses.
1. Audit: Recording of weight/BMI was assessed by retrospective review
of computerized medical records over an 18 month period (n= 117,785) in
40 practices. 50 obese and 50 normal weight patients (age and sex matched)
were randomly selected from 23 practices. (n=1150 obese, 1150 normal weight)
Data is reported on prevalence of obesity-related co-morbidities and differences
in prescribing between the obese and normal weight.
2. Intervention: Patients attended 6 individual appointments (10-20 minutes)
or 6 group sessions (1 hour) with a practice nurse over 3 months and thereafter
were reviewed quarterly. Data are reported from the first 30 practices.
Weight Loss Study Results
1. Audit: Women were more likely than men to have a weight (69.2 percent:
57.0 percent) or BMI (70.6 percent: 57.7 percent) ever recorded. Obese
patients were more likely than normal weight patients to have a recorded
diagnosis of type 2 diabetes (12 percent:3 percent), hypertension (24
percent:12 percent), dyslipidaemia (8 percent:4 percent), cardiovascular
disease (10 percent:6 percent), back pain (16 percent:10 percent), arthritis
(7 percent:4 percent) and gallstones (2 percent:0.2 percent). A higher
percentage of obese, compared to normal weight patients, were prescribed
at least one drug in the following BNF disease categories: gastrointestinal
(25 percent:17 percent), cardiovascular (38 percent:21 percent), anti-hypertensives
(29 percent:14 percent), lipid regulators (12 percent:5 percent), endocrine
(28 percent:18 percent) diabetes drugs (11 percent:4 percent), musculoskeletal
& joint disease (31 percent:22 percent), central nervous system (44
percent:33 percent) and infections (43 percent:35 percent).
2. Intervention: 682 patients were recruited at point of analysis. Mean
age at baseline was 50.8 years and 75 percent of patients were female.
316 patients have now completed 3 months and 199 have completed 6 months.
At baseline 48 percent had at least one obesity related co-morbidity (32
percent hypertension, 15 percent diabetes, 15 percent hyperlipidaemia,
10 percent cardiac co-morbidities). Mean weight loss at 3 months was 3.3kg
while at 6 months it was 4.3 kg. At 6 months 13 percent of patients had
lost >= 10 percent and 43 percent lost >= 5 percent.
Weight Loss Study Conclusion
Obesity can be effectively treated in primary care with modest resources.
The Counterweight program will provide data on treatment efficacy and
outcome that may lead to evidence-based recommendations.
Source: Hazel Ross on behalf of the Counterweight Project Team (2003)
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