Empowering primary care to tackle the obesity epidemic: the Counterweight Programme

• Published in: European journal of clinical nutrition 2005-08, Vol.59 (S1), p.S93-S101
• Main Authors: McQuigg, M, Brown, J, Broom, J, Laws, R A, Reckless, J P D, Noble, P A, Kumar, S, McCombie, E L, Lean, M E J, Lyons, G F, Frost, G S, Quinn, M F, Barth, J H, Haynes, S M, Finer, N, Ross, H M, Hole, D J
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; behavior modification; Body mass index; Body size; Body weight loss; Care and treatment; Clinical Competence; Clinical Nutrition; Cohort Studies; Comorbidity; Counterbalances; Counterweight Programme; diet therapy; dietitians; Empowerment; Epidemics; Epidemiology; Evidence-Based Medicine; Exercise - physiology; Family medicine; Female; general practitioners; Health care; Health Promotion - methods; Humans; Internal Medicine; Intervention; Life Style; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Metabolic Diseases; Middle Aged; morbidity; Nurses; Nursing education; Nutritional Sciences - education; Obesity; Obesity - diet therapy; Obesity - drug therapy; Obesity - therapy; original-communication; Outcome and Process Assessment (Health Care); Patient Compliance; Patient Education as Topic; patients; Physicians (General practice); Physicians, Family; Prevention programs; Preventive medicine; Primary care; primary care physicians; Primary Health Care - methods; Primary Health Care - standards; Project development; Public Health; Self Efficacy; therapeutics; Training; Treatment Outcome; United Kingdom; Weight control; Weight loss
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/sj.ejcn.1602180

Objective: To improve the management of obese adults (18-75 y) in primary care. Design: Cohort study. Settings: UK primary care. Subjects: Obese patients (body mass index greater than or equal to 30 kg/m2) or BMI greater than or equal to 28 kg/m2 with obesity-related comorbidities in 80 general practices. Intervention: The model consists of four phases: (1) audit and project development, (2) practice training and support, (3) nurse-led patient intervention, and (4) evaluation. The intervention programme used evidence-based pathways, which included strategies to empower clinicians and patients. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation. Main outcome measures: Proportion of practices trained and recruiting patients, and weight change at 12 months. Results: By March 2004, 58 of the 62 (93.5%) intervention practices had been trained, 47 (75.8%) practices were active in implementing the model and 1549 patients had been recruited. At 12 months, 33% of patients achieved a clinically meaningful weight loss of 5% or more. A total of 49% of patients were classed as 'completers' in that they attended the requisite number of appointments in 3, 6 and 12 months. 'Completers' achieved more successful weight loss with 40% achieving a weight loss of 5% or more at 12 months. Conclusion: The Counterweight programme provides a promising model to improve the management of obesity in primary care.