Testing the short‐term effectiveness of primary care referral to online weight loss programmes: A randomised controlled trial

Guidelines ask health professionals to offer brief advice to encourage weight loss for people living with obesity. We tested whether referral to one of three online programmes could lead to successful weight loss. A total of 528 participants aged ≥18 years with a body mass index of ≥30 kg/m2 were invited via a letter from their GP. Participants were randomised to one of three online weight loss programmes (NHS Weight Loss Plan, Rosemary Online or Slimming World Online) or to a control group receiving no intervention. Participants self-reported weight at baseline and 8 weeks. The primary outcome was weight change in each of the active intervention groups compared with control. We also compared the proportion of participants losing ≥5% or ≥10% of body weight. For Rosemary, Online mean weight loss was modestly greater than control (-1.5 kg [95% confidence interval (CI) -2.3 to -0.6]) and more than three times as many participants in this group lost ≥5% (relative risk [RR] = 3.64, 95% CI: 1.63–8.1). For Slimming World, mean weight loss was not significantly different from control (?0.8 kg [95%CI ?1.7 to 0.1]), twice as many participants lost ≥5% (RR = 2.70, 1.17–6.23). There was no significant difference in weight loss for participants using the NHS Weight Loss Plan (-0.4 kg, [95% CI -1.3 to 0.5]), or the proportion losing ≥5% (RR = 2.09, 0.87–5.01). Only one of three online weight loss programmes was superior to no intervention and the effect size modest among participants living with obesity

Ancestry proportion distribution.

<p>Median and IQR of the ancestry proportions estimated using genome-wide data and AIMs, per admixed study group.</p

Source population data.

<p>Data sets used to represent the five source populations of the South African Coloured population. The sample size reflects the group size after relative pairs have been removed. Henn et al. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0082224#pone.0082224-Henn1" target="_blank">[52]</a> merged the Juu San data from the Human Genome Diversity Project (HGDP) and Schuster et al. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0082224#pone.0082224-Schuster1" target="_blank">[53]</a> and the African non-San data from Bryc et al <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0082224#pone.0082224-Bryc1" target="_blank">[54]</a>.</p

Barplots of ancestry proportions estimated using genome-wide data and using AIMs.

<p>In the first panel ancestry proportions were estimated using genome-wide data. The admixed study group (sac) is ordered by proportions of African San, African non-San, European, South Asian and East Asian ancestry. In the second panel ancestry proportions were estimated using 96 AIMs. Individuals appear in the same order as in the first panel.</p

Admixture proportion correlation versus number of AIMs in set.

<p>Correlation between admixture proportions estimated using AIMs and proportions estimated using genome-wide data, using AIM sets of increasing size (increments of 25) for the Cape Town study group (n = 733). A proportion of the SNPs in each set of AIMs were selected using the multiple -statistic, indicated in each panel as a percentage, while the remaining SNPs were selected using the pairwise -statistic, as described in the Methods section.</p