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

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

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 analyzed 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 o

A service evaluation of more than 1 million self‐funding adults attending a community weight management programme

Scaled interventions are required to address levels of overweight and obesity and reduce health inequalities. Little data is available on the effectiveness of community weight management programmes for participants self-selecting to attend across different socio-economic backgrounds. This analysis investigates 3, 6, and 12-month outcomes of adults joining a real-life community weight management programme. Weight, attendance and Indices of Multiple Deprivation (IMD) data from all fee-paying adults joining Slimming World in 2016 were collated. Data were analysed using descriptive and inferential statistics to determine predictors of weight loss. Mean BMI of 1 094 676 adults (7.6% male) was 33.0 ± 6.4 kg/m2. Mean % weight change at 3, 6, and 12 months was −5.0% ± 3.6%, −5.9% ± 5.2%, and −6.0% ± 5.8%. Those attending 75% sessions achieved greater weight loss with mean weight losses at 3, 6, and 12-months of 7.7% ± 3.3%, 11.3% ± 5.2%, and 14.1% ± 7.5%, respectively. Effect sizes from comparison of weight change between deprivation deciles were negligible, with similar outcomes in the most and least deprived deciles at 12-months (−5.7% ± 5.9% vs. −6.2% ± 5.9%). This service evaluation of more than 1 million adults attending a community weight management programme found they were able to achieve and/or maintain an average 6% weight loss at 12 months, with high attenders achieving >14% loss. Men and those with higher levels of deprivation were accessing the support and achieving significant weight losses. Slimming World as a real-life, scalable weight management programme is well placed to help adults manage their weight and address health inequalities

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

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