OU2019 Oral Communications Case Discussions: complex clinical cases 1.0 (4 abstracts)
Slimming World, Derby, UK.
Introduction: Slimming World on Referral (SWoR) is a well-established partnership with NHS and local government commissioners, which provides a cost-effective, 12-week, tier-2 weight management intervention for patients, some of whom may meet NICE criteria for tier 3 services. This analysis examines weight loss outcomes by baseline BMI at 3, 6 and 12 months.
Methods: Referrals to Slimming World were made through 80 locally-commissioned schemes across England. Data for analysis included directly measured weight, self-reported height and attendance. Patients were classified as continuers if they continued to attend SW after their initial referral period. Analysis of co-variance (ANCOVA) was used to investigate the effect of baseline BMI category on weight loss outcomes at 3 months.
Results: The number of patients referred to SW between January and December 2016, who met inclusion criteria was 27,733. Of these, 43.1% (n=11,950) had a starting BMI of >25−2 and 56.9% of patients (n=15,783) had a starting BMI >35 kg/m2, which, in the presence of co-morbidities, meets NICE guidance for tier-3 weight management services Mean starting BMI for patients was 37.0±6.0 kg/m2 ranging from 25.0 to 83.3 kg/m2 with 15.6% males. Mean attendance for patients was 9.7 (±3.8) sessions over the 12-week referral period. Mean % weight loss for the >25−2 BMI category vs the >35 kg/m2 BMI category at 3, 6 and 12 months was 5.7±3.8 vs 5.6±3.8, 10.1±5.5 vs 10.0±5.9 and 11.9±6.8 vs 13.0±8.3, respectively. After adjusting for gender and age, ANCOVA revealed no significant differences between BMI categories (P>0.05), with clinically significant weight loss achieved at 3 months for both groups and even larger clinically important weight losses for continuers.
Conclusions: A number of patients referred to SW had baseline BMIs >35 kg/m2. Meaningful weight losses were achieved for patients at 3-months, even in patients who may be eligible for tier 3 weight management services. Those who continued to attend post the 12-week referral continued to lose clinically significant amounts of weight.