Obesity services are a patient postcode lottery


obesity

A lack of consistent reporting on obesity and weight management programmes around the UK has created a postcode lottery for patient care.

Researchers have highlighted the inconsistencies in NHS weight management programmes across the UK in a study published in Obesity Reviews.

A panel of experts, brought together by the researchers, are now hoping their new suggestions on reporting programme successes will help to reduce the postcode lottery of obesity care for patients.

The expert group identified 8 core outcomes and 12 core processes for reporting patient outcomes by weight management services, with a further 11 outcomes and 5 processes identified as optional. These recommendations on how to consistently assess and report on obesity programmes, has already fed directly into guidance by Public Health England and Health Scotland for reporting outcomes from weight management.

Lead author of the study Dr Jennifer Logue, formerly at the University of Glasgow and now at Lancaster University said: “We know that many obesity and weight management programmes are highly effective for patients, however understanding what initiatives work best are key to prolonged funding and best patient care.

“By having the information on how each programme works we can start to better understand what works best for patients. This will lead to improved outcomes for all services, potential cost savings and a move towards less variation in what is delivered.”

Behavioural weight management interventions (BWMIs) are the first line treatment for overweight and obesity. These programmes routinely include patient interventions such as calorie restriction, increased physical activity. However, across the country what patients receive from these programmes is inconsistent – mapping exercises in Scotland and England reveal wide variation in NHS adult weight management services with regard to inclusion criteria, referral routes, delivery format, as well as programme length and cost.

Currently these programmes are evaluated and report on results in different ways, meaning direct comparisons of effectiveness cannot be made between different services.

Dr Logue said: “The lack of consistent and comparable information has led to those who commission and pay for these services showing reluctance to fund more programmes, as there is little evidence of what works best and what does not. By applying a consistent pattern of evaluation to all obesity and overweight programmes, hopefully we will be able to prove just how effective many of these initiatives can be.”

To form the expert panel, the authors of the study used equal numbers on members of the public who have been at weight management in the past, GPs and practice nurses who refer onto the programmes, dieticians, medics, psychologists, programme commissioners, and academics. Each member of the panel’s opinion was given equal weight, such than no one group’s thoughts could dominate.

The study, ‘Core Outcome Set for Behavioural Weight Management Interventions for Adults with Overweight and Obesity: STAndardised Reporting of Lifestyle Weight Management InTerventions to Aid Evaluation (STAR-LITE)’ is published in Obesity Reviews. The work was funded by Medical Research Council (MRC) and the Scottish Government Chief Scientist Office (CSO).


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