Endocrinology, diabetes & metabolism · 2026
Impact of and Comparative Outcomes for Digital and In-Person Interventions for Complex Obesity in a Diverse Urban Population.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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O'Keeffe Majella, Pena-Altamira Emiliano, Shuriye Sumaya, Dunk Danielle, Canfell Oliver, White Rhys, Duncan Alastair
Аннотация
INTRODUCTION: Obesity management in the UK includes multicomponent weight and behavioural interventions delivered at Tier 3 of the NHS model of care. This study presents the impact of and comparative outcomes for the Tier 3 Southeast London Healthy Living programme (SELHLP) in a diverse population.
METHODS: The SELHLP is a multicomponent, multidisciplinary programme that includes face-to-face (F2F) and virtual (V) delivery. Two management strategies are offered: Balance, a weight behavioural intervention and Kickstart, a three-month total meal replacement intervention followed by a weight and behavioural intervention. Eligibility criteria were adults (≥ 18 years) with a BMI ≥ 35 kg/m2. Baseline data and exit data were collected at session 9-12. Primary outcomes included weight change from baseline to programme completion; secondary outcomes included both clinical and behavioural outcomes.
RESULTS: Programme completers of both Balance and Kickstart were predominantly female (82% and 79% respectively). Among completers for Balance, weight change from baseline was -2.8 (8.4) kg for Balance F2F (p < 0.001) and -5.1 (11.7) kg for Balance V (p < 0.001). A similar trend was observed for Kickstart F2F -11 (13) kg and Kickstart V -11 (11) kg (p < 0.001) but did not differ between service delivery models (p > 0.005). 34% of participants of the combined Balance and Kickstart programmes lost ≥ 5% of initial weight, -10.7% and -18% weight loss respectively. Black participants and women were less likely to achieve ≥ 5% weight loss in both programmes, but deprivation status had no effect.
CONCLUSION: The SELHLP resulted in significant weight loss, but weight loss varied by service delivery, ethnicity and sex. Future efforts should focus on cultural salience and digitisation of Tier 3 programmes to support better engagement and completion among participants of Black ethnicity. Tailoring of Tier 3 interventions and triaging of participants at the onset should be investigated to improve both patient and service outcomes.
METHODS: The SELHLP is a multicomponent, multidisciplinary programme that includes face-to-face (F2F) and virtual (V) delivery. Two management strategies are offered: Balance, a weight behavioural intervention and Kickstart, a three-month total meal replacement intervention followed by a weight and behavioural intervention. Eligibility criteria were adults (≥ 18 years) with a BMI ≥ 35 kg/m2. Baseline data and exit data were collected at session 9-12. Primary outcomes included weight change from baseline to programme completion; secondary outcomes included both clinical and behavioural outcomes.
RESULTS: Programme completers of both Balance and Kickstart were predominantly female (82% and 79% respectively). Among completers for Balance, weight change from baseline was -2.8 (8.4) kg for Balance F2F (p < 0.001) and -5.1 (11.7) kg for Balance V (p < 0.001). A similar trend was observed for Kickstart F2F -11 (13) kg and Kickstart V -11 (11) kg (p < 0.001) but did not differ between service delivery models (p > 0.005). 34% of participants of the combined Balance and Kickstart programmes lost ≥ 5% of initial weight, -10.7% and -18% weight loss respectively. Black participants and women were less likely to achieve ≥ 5% weight loss in both programmes, but deprivation status had no effect.
CONCLUSION: The SELHLP resulted in significant weight loss, but weight loss varied by service delivery, ethnicity and sex. Future efforts should focus on cultural salience and digitisation of Tier 3 programmes to support better engagement and completion among participants of Black ethnicity. Tailoring of Tier 3 interventions and triaging of participants at the onset should be investigated to improve both patient and service outcomes.