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A new evidence-based approach to weight management in primary care: the Counterweight Programme

Gibbs, H.D., Brooms, J., Brown, J., Laws, R.A., Reckless, J.P.D., Noble, P.A., Kumar, S., McCombie, E.L., Lean, M.E.J., Lyons, G.F., Frost, G.S., Quinn, M.F., Barth, J.H., Haynes, S.M., Finer, N., Ross, H.M., Hole, D.J. and Montazeri, A. 2004, A new evidence-based approach to weight management in primary care: the Counterweight Programme, Journal of human nutrition and dietetics, vol. 17, no. 3, pp. 191-208, doi: 10.1111/j.1365-277X.2004.00517.x.

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Title A new evidence-based approach to weight management in primary care: the Counterweight Programme
Author(s) Gibbs, H.D.
Brooms, J.
Brown, J.
Laws, R.A.ORCID iD for Laws, R.A. orcid.org/0000-0003-4328-1116
Reckless, J.P.D.
Noble, P.A.
Kumar, S.
McCombie, E.L.
Lean, M.E.J.
Lyons, G.F.
Frost, G.S.
Quinn, M.F.
Barth, J.H.
Haynes, S.M.
Finer, N.
Ross, H.M.
Hole, D.J.
Montazeri, A.
Journal name Journal of human nutrition and dietetics
Volume number 17
Issue number 3
Start page 191
End page 208
Total pages 18
Publisher Wiley
Place of publication London, Eng.
Publication date 2004-06
ISSN 1365-277X
Keyword(s) general practitioner
nutrition education
obesity
practice nurse
primary care
treatment models
Summary Background/Aims Obesity has become a global epidemic, and a major preventable cause of morbidity and mortality. Management strategies and treatment protocols are however poorly developed and evaluated. The aim of the Counterweight Programme is to develop an evidence-based model for the management of obesity in primary care.

Methods The Counterweight Programme is based on the theoretical model of Evidence-Based Quality Assessment aimed at improving the management of obese adults (18–75 years) in primary care. The model consists of four phases: (1) practice audit and needs assessment, (2) practice support and training, (3) practice nurse-led patient intervention, and (4) evaluation. Patient intervention consisted of screening and treatment pathways incorporating evidence-based approaches, including patient-centred goal setting, prescribed eating plans, a group programme, physical activity and behavioural approaches, anti-obesity medication and weight maintenance strategies. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation. Eighty practices were recruited of which 18 practices were randomized to act as controls and receive deferred intervention 2 years after the initial audit.

Results By February 2004, 58 of the 62 (93.5%) intervention practices had been trained to run the intervention programme, 47 (75.8%) practices were active in implementing the model and 1256 patients had been recruited (74% female, 26% male, mean age 50.6 years, SD 14). At baseline, 75% of patients had at one or more co-morbidity, and the mean body mass index (BMI) was 36.9 kg/m2 (SD 5.4). Of the 1256 patients recruited, 91% received one of the core lifestyle interventions in the first 12 months. For all patients followed up at 12 months, 34% achieved a clinical meaningful weight loss of 5% or more. A total of 51% of patients were classed as compliant in that they attended the required level of appointments in 3, 6, and 12 months. For fully compliant patients, weight loss improved with 43% achieving a weight loss of 5% or more at 12 months.

Conclusion The Counterweight Programme is an evidence-based weight management model which is feasible to implement in primary care.
Language eng
DOI 10.1111/j.1365-277X.2004.00517.x
Field of Research 110699 Human Movement and Sports Science not elsewhere classified
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2004, Wiley
Persistent URL http://hdl.handle.net/10536/DRO/DU:30083492

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