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Obesity Management Program - Counterweight
Evaluation of the Management of Obesity in Primary Care
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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

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