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
Initially we will run test groups to establish if PROGROUP will work on a larger scale, following which we will randomly allocate recruited patients to the new service if they are willing to be involved in the study. This stage will include 120 patients at three clinics, receiving weight management services, with or without the new group programme. If successful we will move to a large trial in the final stage.
The large scale study will take place in 10 centres around the UK involving 1,100 patients. After 12 months we will measure weight loss, cost-effectiveness of treatment, and other impacts that patients say are important to them. We will then compare the PROGROUP programme to the old service.
Patient and public involvement
We have formed a patient and public consultation group which will be central to developing and setting-up PROGROUP, and in identifying the impacts from the trial that are most relevant to patients.
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.
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). The 5 year research study will begin in 1st May 2021.
Do you lead, or work in specialist weight management (Tier 3) services? Could you complete our national survey to help researchers understand more about how services choose to provide their programmes and how COVID-19 has changed this?
For more information, see the project’s publication on group-based intervention for people with severe obesity:
We receive ongoing support from The Association for the Study of Obesity.
Tarrant M, Khan SS, Farrow CV, Shah P, Daly M, Kos K (2017). Patient experiences of a bariatric group programme for managing obesity: A qualitative interview study. British Journal of Health Psychology, 22, 77-93.
Steele, T , Narayanan, RP , James, M , James, J , Mazey, N and Wilding, JPH (2017). Evaluation of Aintree LOSS, a community-based, multidisciplinary weight management service: outcomes and predictors of engagement. Clinical Obesity, 7 (6). 368 – 376.
Borek, A. J., Abraham, C., Greaves, C. J. and Tarrant, M. (2018), Group-Based Diet and Physical Activity Weight-Loss Interventions: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Appl Psychol Health Well-Being.
Tarrant M, Warmoth K, Code C, et al (2016). Creating psychological connections between intervention recipients: development and focus group evaluation of a group singing session for people with aphasia. BMJ Open, 6(2).
Farrow CV, Tarrant M, Khan SS (2017). Using social identity to promote health: The impact of group memberships on health in the context of obesity. In: Buckingham S, Frings D, Albery IP, eds. Addiction, Behavioural Change and Social Identity: Routledge.