Background
Severe obesity reduces life expectancy due to potential development of diabetes, heart disease and cancer. People with severe obesity also report greatly impaired quality of life. One treatment option is weight-loss surgery, but few people choose this, and other treatment options are limited.
The NHS provides specialised weight management services for people with severe obesity, but what these Tier 3 clinics do, and how effective they are is unclear. Our project seeks to better understand these clinics and investigate whether a new facilitator-led, intensive, group-based behavioural programme (PROGROUP) is more effective and less costly than usual care for people with severe obesity.
Aim of the research
The aim is to adopt best practice for group based treatment in Tier 3 weight management and to establish whether PROGROUP is in fact more effective and less costly than NHS usual care.
Design and methods
The Feasibility Trial
Initially we ran three test groups to establish if PROGROUP would work on a larger scale, following which we randomly allocated recruited patients to the new service if they were willing to be involved in the study. This stage included up to 100 patients at three clinics, receiving weight management services, with or without the new group programme. If this stage was successful, we would move to a large trial in the final stage of the research.
The Main Trial
This large-scale study will take place in approximately 8 centres around the UK and involve up to 1,000 patients. As in the feasibility trial, patients will receive either PROGROUP or usual care. This will be decided by a computer. After 12 months we will assess each participant’s weight and determine whether the PROGROUP intervention improves patients’ health. We will also assess whether the intervention is cost-effective for the NHS.
Patient and public involvement
A patient advisory group and an implementation advisory group was set up, which has been central to developing and setting-up PROGROUP, and in identifying the impacts from the trial that are most relevant to patients.
These groups met virtually and also provided feedback to the research team on an individual basis. Both groups have been invaluable in providing feedback on the project plans and materials.
Hear our Patient and Public Involvement (PPI) group member Steve Perry talk about the importance of including a PPI perspective in the study:
Dissemination
Our findings as to delivery of successful services that meet patients’ needs will be shared regionally, nationally and internationally with the help of the patient expert consultation group. We will do this through weight management groups we have worked with and our many stakeholders –including Association for the Study of Obesity, British Dietetic Association, commissioners and NHS England. The results will also be published by press releases, newsletters, social media and in health journals.
Project activity
Working with a national team of specialist service providers, service users, Tier 3 commissioners, dietician, psychological and implementation science experts we have devised a proposal to optimise how the dynamics of how a group-based service for people with severe obesity may be developed and used.
In September 2020 the project was awarded nearly £2.5 million from the National Institute for Health Research (NIHR) and the 5-year research study began on 1st May 2021.
The feasibility stage of this project concluded in the Autumn of 2023, and the team carried forward the knowledge gained, from data collected and from discussions at the final feasibility trial Stakeholder meeting, consultations with our steering committee, project management group and patient advisory group. Providing insights to inform, improve and refine intervention materials and the training plan for facilitators delivering the intervention, and all participant-facing documents. You can read more about the feasibility trial here: https://theprogroupstudy.co.uk/the-trials/feasibility-trial/
Thanks to the efforts of our participating sites and to the willingness of participants to be involved in the feasibility work, we successfully progressed to the main trial.
Next steps
PROGROUP sites continue to work incredibly hard recruiting patients, running PROGROUP sessions and providing lots of valuable insights.
During 2024, one of our sites completed the first delivery of the new PROGROUP intervention in full and are moving onto their third. They are also supporting us, giving feedback attending interviews with the researcher team.
Acknowledgements
We are grateful for the support from the research Sponsor for this study, University Hospitals Plymouth NHS Trust, and our public and patient advisory group for their input in developing this research.
We are incredibly grateful to have such fantastic PROGROUP sites across the country, all working incredibly hard on our behalf.
World Obesity Day, is a unified day of action that calls for a cohesive, cross-sector response to the obesity crisis. Convened by the World Obesity Federation in collaboration with its global members.
You can read more about it on the World Obesity Organisation website, here: About WOD | World Obesity Day
The World Obesity Federation have collated a range of really useful technical resources, visit here to access campaign assets and other resources.
Related publications
Development of a Group-based Behaviour Change Intervention for People with Severe Obesity Informed by the Social Identity Approach to Health
Download the BiteEffective components of behavioural weight management interventions for people with obesity: A rapid review of systematic reviews
Download the BiteThe effectiveness and usability of online, group-based interventions for people with severe obesity: a systematic review and meta-analysis.
Download the Bite
A group-based behavioural intervention for weight management (PROGROUP) versus usual care in adults with severe obesity: a feasibility randomised controlled trial protocol
Download the PaperThe Effectiveness and Usability of Online, Group-Based Interventions for People With Severe Obesity: Protocol for a Systematic Review
Download the PaperHow group-based interventions can improve services for people with severe obesity.
Download the PaperGroup-Based Diet and Physical Activity Weight-Loss Interventions: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Download the PaperPatient experiences of a bariatric group programme for managing obesity: A qualitative interview study
Download the PaperCreating psychological connections between intervention recipients: Development and focus group evaluation of a group singing session for people with aphasia
Download the PaperResources
Collaborators
- Professor Jonathan Pinkney, Co-Principal Investigator
- Rod Taylor, Implementation
- Professor J Wilding & Mrs Sarah Hind, Service Leads, University of Liverpool
- Mary O'Kane, Leeds Teaching Hospital
- Peninsula Clinical Trials Unit, University of Plymouth
- Steve Perry, Patient & Public Involvement (PPIE)
- Dr Sarah Baldrey, Clinical Psychologist, University of Plymouth
- Professor Anne Spencer, Health Economics, University of Exeter
- Professor Siobhan Creanor, Statistician, University of Exeter
- Dr Jo Hosking, Statistician, University of Plymouth
- Ruth Hastings, Finance
- Lucy Evans, Laura Gill & Caroline Quinn, Administrators & coordinators
- Dr Jenny Lloyd, Dr Lily Hawkins, Dr Shok Oftadeh Moghadam & Dr Laura Hollands, University of Exeter
PenARC Staff

Professor Rod Sheaff
Professor in Health Services Research
Professor Sarah Dean
Professor of Psychology Applied to Rehabilitation and Health
Professor Adrian Taylor
Professor of Health Services Research
Lorna Burns
Information Specialist