According to a new study published on bmj.com nearly a fourth of England's population is classified as obese. The study also shows that weight loss programs led by specially trained staff at primary care based services are more expensive and less effective than commercial programs, which are evidently more efficient, although the effectiveness of primary care based programs remains unclear.
In order to compare the effectiveness of several commercial weight loss programs with programs led by primary care and a control group, researchers at the University of Birmingham enrolled 740 obese individuals to participate in programs of 12 weeks duration. Follow-up data were available for 658 (89%) of the participants at the completion of each 12-week program and 522 (71%) at one year.
The six programs included in the study were Rosemary Conley, Weight Watchers, Slimming World, general practice one to one counseling, pharmacy one to one counseling and a group-bases dietetics programs. Participants were given the choice of any of the programs. In addition a control group was provided with 12 vouchers for free entrance to a local leisure (fitness) center.
After 12 weeks all programs achieved considerable weight loss, the average weight loss ranged from 4.4kg (9.7lbs) at Weight Watchers to 1.4kg (3.08lbs) at a general practice provision. The researchers discovered that at 12 weeks the primary care programs were not better than the control group.
In addition they found that at one year, all participants had statistically lost a considerable amount of weight apart from those who took part in the one to one programs in general practice and pharmacy settings. Although, Weight Watchers was the only program to achieve considerably greater weight loss than the control group.
The researchers observed that although physical activity increased across all groups, those in the general practice program showed the smallest increase. They also found that attendance appeared to be an important factor. Weight Watchers had the highest attendance rate compared to primary care programs which were also the most expensive.
The authors explain:
"Our findings suggest that a 12 week group based dedicated program of weight management can result in clinically useful amounts of weight loss that are sustained at one year.
Commercially provided weight management services are more effective and cheaper than primary care based serviced led by specially trained staff, which are ineffective."
In an associated report, nutrition experts Helen Truby and Maxine Bonham at Monash University in Australia said: "Lighten Up shows that there is no simple solution to the obesity epidemic."
According to the researchers the NHS should be aware of the level on investment required in order to develop its own expert workforce to manage complex obesity, and that the NHS can gain significant information regarding the way commercial companies deliver what consumers want.
Written by Grace Rattue