Behavioural approaches to weight loss do work
Randomised controlled trials compare effects of brief advice and self-help materials, with a long-term weight management programme
Obesity is a major public health issue. An effective strategy for management of obesity is primary care referral to an open-group behavioural programme, but the optimum duration for the programme is uncertain.
This randomised controlled trial compared the effect of brief advice and self-help materials, with a weight management programme (Weight Watchers) for 12 weeks (current practice), with the same weight management programme for 52 weeks.
The trial recruited 1267 participants with a body mass index (BMI) of 28kg/m2 or higher from 23 practices in England and followed up for two years. At year one the brief intervention was not effective, with the 52-week programme significantly more effective than the 12-week programme (mean weight loss was 3.26kg, -4.75kg, and -6.76kg respectively).
Differences between groups were still significant at two years. Two-year costs were higher for the 52-week programme (£159 per kg lost vs £91 per kg lost for the 12-week programme) but when modelled over a longer time period were found to be cost effective.
Behavioural programmes are therefore cost-effective for weight management.
Ahern AL, Wheeler GM, Aveyard P, et al (2017) Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial. The Lancet. doi: 10.1016/S0140-6736(17)30647-5.