Platform for Health and Wellbeing pilot study: provision of weight management support via the workplace

Introduction: The role of the workplace as an opportunity for improving health has been highlighted in recent reports. The East Midlands Platform for Health and Wellbeing is a network of private, public and voluntary sector organisations working to improve health and reduce obesity. Member organisations commit to undertake actions to improve health and wellbeing of employees, individuals and/or communities. As part of Slimming World’s commitment, this pilot assessed the merits of providing weight management support via the workplace at two large regional employers. Methods: 278 British Gas and Nottingham University Hospitals NHS Trust employees were offered 12 weeks’ support at either a bespoke workplace group or established community-based Slimming World group. Weight change was recorded weekly. Dietary and physical activity behaviours, along with aspects of psychological health were assessed by questionnaire pre and post-programme. Results: 121 employees (meeting inclusion criteria) joined a workplace-based group and 114 a community-based group. Weight and attendance: Mean joining BMI was 32.4kg/m2. 138 (59%) participants completed the programme (attended within final 4 weeks).Behaviour changes: Participants who completed both questionnaires (n=87), reported positive changes in dietary and physical activity behaviours (all p<.001) (figure 1), and psychological health (mental wellbeing, self-worth and self-esteem, all p<0.05). There were no significant differences between worksite and community intervention groups for any outcomes. Conclusion: Providing weight management support via the workplace significantly reduced weight of participants (-3.9%). Completer analysis also revealed positive changes in healthy eating habits and activity levels, and also importantly psychological health, which may impact on working life. The Slimming World programme works effectively within both the work setting and via community-based provision when employees are recruited via the workplace

Factors influencing engagement in postnatal weight management and subsequent weight and well-being outcomes

Many women exceed gestational weight gain recommendations. Successful postnatal weight management decreases the risk of entering further pregnancies obese. This service evaluation investigates women’s motivations to lose weight postnatally, the weight loss achieved and impact on self-esteem. Methods: online survey using quantitative questions to determine motivation and lifestyle behaviours related to post-natal weight management in women attending a commercial weight management organisation. Weekly weights confirmed from digitally recorded data. Results: 1015 responded. Mean joining BMI was 33.3kg/m2 ± 5.85 and when surveyed 30.5kg/m2 ± 5.86, a change of -2.8 ± 0.1 kg/m² (p <0.01, 95% CI 2.76 – 3.11). 463 (45.7%) joined the groups between 6-26 weeks postnatal. Main motivators to lose weight were ‘to improve how I feel about my body size and shape’ (85.2%) and ‘improve self-confidence’ (76.6%) although only ‘to improve my health’ (65.6%) correlated with actual weight loss (0.114, p<0.01). Healthcare professional recommendation was less of a reason (6.5%). Improvements in self-confidence (77.6%), self-esteem (78.6%), wellbeing (85.2%) and body size/shape (70.1%) were reported. Conclusion: Women chose to engage to improve self-confidence, feelings about their body shape and health. There is an opportunity for healthcare professionals to encourage women early after giving birth to engage in weight loss and this may improve outcomes

Changes in self-esteem in participants associated with Weightloss and Maintenance of Commercial Weight Management Programme

Introduction and methods: This study examined associations between weight loss, its maintenance and self-esteem in 292 members of a commercial weight management organisation, Slimming World. Self-esteem was measured with the Rosenberg self-esteem questionnaire adapted to 5-point Likert scales. Associations between dimensions of self-esteem and weight change were examined by correlation and regression using the GENSTAT 5 statistical program. Results: Mean (SD) weight on joining the CWMO was 89.0 (20.0) kg; time taken to reach current weight was 16.3 (13.5) months. Mean (SD) weight change was -15.6 (11.4) kg and BMI change was -5.7 (4.0) (both p < 0.001), maintained for 11.7 (12.8) months. Percent variance in weight change associated with each component of self-esteem is given in parentheses. All weight changes were negative. Participants reported a decrease in sense of failure (3.9%) and an increase in self-respect (3.0%) and self-pride (2.4%). Self-satisfaction (12.8%), feelings of self-achievement (10.6%), positive attitudes towards themselves (9.9%), sense of self-worth (10.6%) and self-efficacy (7.3%) all significantly increased in association with reaching and maintaining their current weight (all p < 0.001). Multiple regression analysis showed that age, gender, height and start weight accounted for 35.4% of the variance in weight change. Self-esteem components of the model accounted for 50.4% of the variance in weight change. Conclusion: Successful weight loss and maintenance was associated with significant reported improvements in self-esteem in members of a Commercial Weight Management Organisation

Studying the impact on weight and glycaemic control in adults with diabetes attending a group-based commercial weight management programme

Abstract Most NHS weight management and diabetes education is short term, so can the more sustained support provided by commercial weight loss programmes prove a useful ally in treating obesity and diabetes? Here the authors evaluate a survey that suggests it can Healthcare professionals could work in partnership with commercial group weight management programmes (CGWMP) to help people with diabetes lose weight and improve their glycaemic control. The effect of ongoing CGWMP support on diabetes control has not previously been reported. This study evaluates weight loss and glycaemic control in people with diabetes attending a CGWMP. Method: A cross-sectional online survey posted on a CGWMP's member's website. The survey asked for reported changes in HbA1c and physical activity and demographics including age, type of diabetes, medications taken and healthcare professional support. The dataset was linked to electronically reported weight and attendances. Data was statistically analysed to assess percentage of individuals meeting targets for weight reduction and HbA1c and outcome changes with variation between genders, type of diabetes and support. Results: 620 respondents with mean weight loss of 10.0±8.0%; 157 reported a mean reduction in HbA1c of 18±21mmol/mol (1.6±1.9%). 58.2% lost >10% body weight after 24 weeks and 51.5% had achieved HbA1c of 5% weight reduction was associated with diabetes medication reduction (p=0.028) and improved glycaemic control (p=0.001). Conclusion: Support provided by the CGWMP resulted in clinically significant weight losses and improvements in HbA1c with reductions in diabetes medication. Attendance at CGWMPs may be an effective long-term strategy and a scalable option to help improve diabetes control

Eating habits associated with body weight gain in female university students : a UK-based study of Slimming World members

Purpose: To examine dietary habits, cooking skills, physical activity levels and perceived reasons for weight gain in relation to levels of body weight gain among university students in the UK. Design/methodology/approach: This study explored factors associated with body weight gain in a cross-sectional study of British university students who were actively trying to lose weight. University student members of a national commercial slimming programme completed an online survey about weight gain, eating habits, cooking abilities and physical activity levels. Non-parametric tests and regression analysis were employed to examine factors associated with weight gain. Findings: The dataset comprised 272 current students. The majority of students (67%) reported weight gain between 3.2 and 12.7 kg during university: 20.4% reported to have gained >12.7 kg. Students commonly attributed their weight gain to academic stress and nearly all identified with needing support to learn to cook on a budget. Students reporting greatest weight gain had most frequent consumption of ready meals & convenience foods, take-away & fast foods, and least frequent consumption of fruits & vegetables. Weight-stable students reported lowest consumption of alcohol and were most able to cook complex meals. Students who reported greatest weight gain reported lower physical activity levels. There were inter-correlations between cooking ability and lifestyle factors. In a multivariate model, low physical activity and frequent consumption of ready meals and convenience food independently predicted weight gain. Research limitations/implications: Prospective studies are needed to confirm these cross-sectional associations and to qualitatively explore how the university setting may contribute to the effects. Practical implications: Strategies to address students’ reliance on fast and convenience food, avoidance of fruit and vegetables, poor cooking confidence and low physical activity may benefit student health and well-being. Social implications: Originality/value: The study adds additional perspective to understanding student weight gain at university in that it focuses on a a body weight-conscious sub-group of the student population, as opposed to the general population of student

Weight loss outcomes achieved by adults accessing an online programme offered as part of Public Health England’s ‘Better Health’ campaign

Effective use of health technology may offer a scalable solution to the obesity pandemic. Online digital programmes provide a convenient and flexible way for more people to access regular support. This service evaluation aims to determine whether adults accessing an online weight management programme via a national campaign are successful in losing weight. Data was analysed for adults registering with Slimming World’s online programme using a discounted membership offered as part of PHE’s ‘Better Health’ campaign between July and December 2020. Last-weight carried forward was used to calculate weight outcomes for participants who had the opportunity to complete 12-weeks and recorded ≥ one weight besides baseline. Engagement was determined using number of online weekly weights recorded with high engagers having weight data for ≥ 9 occasions. Socioeconomic status was assessed using postcode data. Resubscription and uploaded weight data were used to determine numbers who continued beyond the offer period. Twenty-seven thousand two hundred forty-eight adults (5.3% males) with mean age 41.0 ± 11.4 years met inclusion criteria. Mean baseline BMI was 33.4 ± 6.8 kg/m2 (29.2% 30–34.9, 18.3% 35–39.9 and 15.1% > 40 kg/m2). Mean weight loss at 12 weeks was 2.7 (± 3) kg representing a mean loss of 3% (± 3.1) body weight with 42.3% achieving ≥ 3% and 22.1% weight loss ≥ 5%. Median number of weigh-ins was six. Men had greater weight losses compared to women (p 0.05). 30.9% were in the lowest two IMD quintiles and absolute and percentage weight change did not differ across deprivation quintiles (p > 0.05). 34.9% continued to access the online support after the offer period. This service evaluation shows that an online programme, offered as part of a national campaign, can offer effective support to a large number of people with different starting BMIs and from different socioeconomic backgrounds. An increased level of engagement leads to better weight losses

Service evaluation of weight outcomes as a function of initial BMI in 34,271 adults referred to a primary care/commercial weight management partnership scheme

Peer reviewedPublisher PD

Impact of COVID-19 on health-related behaviours, well-being and weight management

Background: Weight management is complex for people even in times of stability. Supporting individuals to develop strategies to maintain a healthier weight when there are additional life challenges may prevent relapse. This mixed-methods study describes the impact the COVID-19 restrictions had on adults engaged in weight management before and during the pandemic in order to determine helpful strategies. Methods: Longitudinal data was captured from online surveys completed by Slimming World (SW) members 0–4 weeks after joining, October/November 2019, providing pre-joining and baseline (T0&T1), 3- (T2) and 6- month (T3-during COVID-19) data. Representatives from the general population, not attending a weight management service, completed the same questionnaires providing cross-sectional control data. All weights are self-reported. For this study, questions assessing the impact of the COVID-19 challenges on health-related behaviours and well-being are included comparing responses at T0/T1, T2 & T3. Longitudinal data were analysed using repeated measures ANOVA and cross-sectional data, one-way independent ANOVAs to compare means. Comparisons between SW members and controls were determined using z-proportion tests. Qualitative data generated was thematically analysed using a six-step approach to produce the key emerging themes. Results: 222 SW members completed all three surveys, achieving a weight loss of 7.7 ± 7.5%. They maintained positive health-related behaviour changes made since joining, including increased fruit and vegetables (p< 0.001), fewer sugary drinks (p< 0.001), cooking from scratch (p < 0.001) and increased activity levels (p < 0.001). Despite COVID-19 restrictions, they were still reporting improvements in all behaviours and had healthier scores than the controls on all but alcohol intake, although still within guidelines. Qualitative data indicated that the situation created various challenges to managing weight with fresh foods harder to access, comfort eating, drinking more alcohol, eating more sugary foods and snacking through boredom. However, some reported having more free time enabling better planning, more time to cook from scratch and increased physical activity. Conclusions: The findings highlight the value of peer, group and online support and guidance for individuals to develop sustainable behaviour changes and a level of resilience. These strategies can then be drawn upon enabling maintenance of lifestyle changes and management of weight even in challenging times

Weight outcomes audit in 1.3 million adults during their first 3 months' attendance in a commercial weight management programme

Background: Over sixty percent of adults in the UK are now overweight/obese. Weight management on a national scale requires behavioural and lifestyle solutions that are accessible to large numbers of people. Evidence suggests commercial weight management programmes help people manage their weight but there is little research examining those that pay to attend such programmes rather than being referred by primary care. The objective of this analysis was to evaluate the effectiveness of a UK commercial weight management programme in self-referred, fee-paying participants. Methods: Electronic weekly weight records were collated for self-referred, fee-paying participants of Slimming World groups joining between January 2010 and April 2012. This analysis reports weight outcomes in 1,356,105 adult, non-pregnant participants during their first 3 months’ attendance. Data were analysed by regression, ANOVA and for binomial outcomes, chi-squared tests using the R statistical program. Results: Mean (SD) age was 42.3 (13.6) years, height 1.65 m (0.08) and start weight was 88.4 kg (18.8). Mean start BMI was 32.6 kg/m² (6.3 kg/m²) and 5 % of participants were men. Mean weight change of all participants was −3.9 kg (3.6), percent weight change −4.4 (3.8), and BMI change was −1.4 kg/m² (1.3). Mean attendance was 7.8 (4.3) sessions in their first 3 months. For participants attending at least 75 % of possible weekly sessions (n = 478,772), mean BMI change was −2.5 kg/m² (1.3), weight change −6.8 kg (3.7) and percent weight change −7.5 % (3.5). Weight loss was greater in men than women absolutely (−6.5 (5.3) kg vs −3.8 (3.4) kg) and as a percentage (5.7 % (4.4) vs 4.3 % (3.7)), respectively. All comparisons were significant (p < 0.001). Level of attendance and percent weight loss in the first week of attendance together accounted for 55 % of the variability in weight lost during the study period. Conclusions: A large-scale commercial lifestyle-based weight management programme had a significant impact on weight loss outcomes over 3 months. Higher levels of attendance led to levels of weight loss known to be associated with significant clinical benefits, which on this scale may have an impact on public health