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BEhavioural Weight Management: COMponents of Effectiveness (BE:COME)

Find out about this research project and what it aims to achieve.

The study is looking at a number of different Local Authorities, NHS and commercial providers who already run different types of weight loss programmes. We talked to a group of people who had varied experiences of achieving weight loss and maintaining it, successful or otherwise. It is a mixed group of experienced Patient and Public Involvement representatives and newcomers. The group looked at what aspects of the programmes they felt would have the most impact based on their experience, for example; whether they are accessible, take place face to face or online, how long the programme lasts, meeting dynamics, mechanisms for monitoring, incentives or a mixture of these. These were matched to the information already available across a number of different programmes and closely analysed using component network meta-analysis with input from PPI representatives to find out which seemed to be most effective in supporting people to lose weight and maintaining it.

What is this research about?

Behavioural weight management interventions (BWMIs) are the main publicly funded interventions for obesity in the UK but there is high intervention variability including by mode of delivery, dietary, physical activity and behavioural components.

Most often these are community-based groups which meet weekly for 12 weeks, focusing on diet, physical activity and behavioural change. There are national guidelines on what a BWMI should contain, but they are vague and only cover a small part of what makes up a BWMI. It has been difficult to compare BWMIs and see what works best because researchers have used different ways to describe the weight-loss results in studies, or do not fully describe what the BWMIs involved for participants.

BWMIs are complicated and they can be made up of very different parts. For example, one BWMI may have exercise classes every week but another may simply give advice on being more active. These differences are seen across the recommended diets, the help for people to plan and stick to the BWMI (like keeping a diary of what you eat or setting targets for how much weight to lose), and things related to how the BWMI is run, such as the training of the staff or how far people need to travel to take part. No one is sure what works best. It may be that the same BWMI will not work as well for everyone; younger adults, men, ethnic minorities or those from deprived backgrounds may have different needs. As there is doubt as to what types of BWMIs work best, in many areas of the UK BWMIs are not funded at all.

We want to find out which parts of BWMIs are linked to weight-loss, and what the best combination of parts is for different groups of people taking part.

How will the study be carried out?

  • We have agreements from BWMIs in the England to share data on who attended their programme and their change in weight.
  • We also have permission to re-use data from research trials of UK BWMIs that finished in the last 10 years.
  • We will be working closely with each BWMI so we can describe them in detail.
  • A group of expert advisors (including members of the public) will decide on around 10 parts of BWMIs for us to study that they think may be related to better completion rates and higher weight loss, and yet are not part of every BWMI just now.
  • The research trials and real-life BWMIs will then be compared using a special technique called component network meta-analysis. This technique allows the different parts that make up the BWMIs to be compared. By doing this for a range of groups of people we will be able to say which parts of the BWMIs are linked to weight loss for each group.
  • For any part that is linked to weight loss, we will work out if the likely health benefits outweigh the costs of delivering it.

How will we involve the public?

Three members of the public with personal experience of weight management will be part of the advisory group and one further person will be on the main research team. As well as selecting the BWMI parts to be studied, we will ask them for guidance on putting the results into practice and sharing them with the public. We will also ask key existing patient involvement groups, such as young people from deprived backgrounds and ethnic minority communities, for their opinions.

How will we share the results?

At the end of the study we will invite the BWMIs that took part, the advisory group (including public members), and policy-makers from across the UK, to attend a one-day meeting. We will present the results and work together to create a practical guide for adding these parts into BWMIs across the UK.

National Institute of Health Research funded project

Find out more about the project here.


Meet our Patient and Public Involvement team

This research project involves members of the public because we beleive that good research should include the public and not just be about them.

Meet the BECOME PPI team

Our latest news and updates

Keep up to date on the latest news on the project.

Information and publications

Reports, conference materials and publications from the BECOME study can be found here.

  • Publications and Reports
  • Conference presentations
  • Rebecca Gregg, Sahar Sharif, Alison Avenell, Louisa Ells, Nishant Jaiswal, Sandra Jayacodi, Ruth Mackenzie, Sharon Simpson, Olivia Wu, Jennifer Logue. BEhavioural Weight Management: COMponents of Effectiveness (BE:COME): Descriptive data findings. ASO UKCO 8th September 2022.

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NIHR Funded

This study/project is funded by the National Institute for Health Research Health Technology Assessment programme (NIHR129523). The views and opinions expressed are those of the authors and not necessarily reflect those of the Health Technology Assessment programme, the National Institute for Health Research, NHS or the Department of Health and Social Care.