Comparison of baseline characteristics and weight loss outcomes in patients with extreme obesity attending a weight management focussed structured educational group or a specialist community weight management service

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 695-707-Obesity Treatment
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-705
Alison Clare Jagielski*1, Adrian Brown2, Amy Gouldstone2, Alice Wright2, Rhian Davies2, Gillian Abernethy2, G Neil Thomas3 and Shahrad Taheri2
1University of Birmingham, Birmingham, United Kingdom, 2Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, United Kingdom, 3Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom
Rates of obesity continue to rise and there remains no consensus on the best treatment. Currently two different treatment pathways run within our specialist weight management service: the Specialist Lifestyle Management (SLiM) is a monthly medically supported, structured patient education group, and the specialist Community Weight Management Service (CWMS) providing individualized multi-disciplinary team (MDT) care from specialist physicians, dietitians, and psychologist. We compared the baseline characteristics, quality of life, and weight loss outcomes of the two treatment approaches.

A retrospective service evaluation of 747 patients with extreme obesity (EO) attending either SLiM (477) or CWMS (270) was conducted. Demographic information and Impact of Weight on Quality of Life (IWQOL-Lite) questionnaires were taken on entering the service. Age was 46.5±12.1yrs, female 74.2%, White European 82.7% and type 2 diabetes 28.6%.

Both CWMS and SLiM produced statistically and clinically significant weight loss in patients with EO, losing 4.4±9.2kg (3.6±7.6%, p<0.001) and 5.3±7.0kg (3.7±4.6%, p<0.001), respectively. Weight loss was achieved in a high percentage of patients; however, SLiM achieved it in a significantly greater proportion (83.8% vs 72.1%, <0.001); of these patients, weight loss was greater 7.3±9.0kg (6.0±7.5%) and 6.9±6.4kg (4.9±4.1%) for CWMS and SLiM respectively. Both groups reported low quality of life, with no significant difference in total IWQOL-Lite scores of 34.4±19.4 for the SLiM patients and 39.7±22.4 for the CWMS patients (p=0.92) where 100 represents optimum quality of life. However, there were significant differences in several baseline characteristics, with SLiM patients being significantly older (48.3 vs. 43.5yrs, <0.001), heavier (136.3 vs. 131.9kg <0.05), of greater BMI (49.6± vs. 46.9kg/m2, <0.001) and reporting worse physical function (31.6 vs 42.8, <0.05). There was no significant difference in mean weight loss (p=0.83), despite SLiM having a potentially more challenging patient group with more complex needs.

This evaluation highlights the efficacy of two medically supported weight management services, indicating that both approaches achieve successful weight loss outcomes in EO. The use of an MDT approach can lead to clinically significant weight loss, thus improving obesity related outcome even in patients with EO and complex care needs. Further work is underway to determine improved tailoring of interventions to patients.

Disclosure: AB: Speaker, Sanofi, Speaker, Allergan. ST: Clinical Researcher, Lilly USA, LLC, Clinical Researcher, Novo Nordisk. Nothing to Disclose: ACJ, AG, AW, RD, GA, GNT

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