Association of clinically significant weight loss with number of patient visits and months of attendance at an Australian multidisciplinary weight management clinic

Abstract

Summary Despite the obesity epidemic, there are relatively few multidisciplinary obesity services in Australia, and only limited data on the effectiveness of these services. The aim of this study was to evaluate the effectiveness of a university hospital‐based weight management clinic—the ‘Healthy Weight Clinic’ in supporting patients to achieve clinically significant weight loss (≥5% reduction in body weight), weight maintenance, and changes in body composition. A retrospective review was conducted to determine weight and associated health outcomes in patients who attended an initial consultation in the first 2 years of the clinic—between March 2017 and March 2019. Follow up was at least 1 year for all patients. Patients who underwent bariatric surgery were excluded. Of 213 total patients, 172 patients attended more than one follow‐up consultation for lifestyle modification. Mean weight change and percentage total weight change at last follow‐up was −6.2 kg (SD 7.4) and − 6.0% (SD 6.9), respectively. For every additional clinic follow‐up, there was 21.4% increased odds of achieving clinically significant weight loss, and for every additional month of follow‐up, there was 10.1% increased odds of achieving clinically significant weight loss. Twenty percent of patients (34/172) maintained ≥5% of initial body weight loss for at least 1 year. Body composition measurements were also favourable, with significant changes in percentage skeletal muscle mass of +0.8% (SD 1.5) and in percentage fat mass by −1.4% (SD 3.2). Regular support in a structured holistic multidisciplinary obesity service enables patients to achieve clinically meaningful weight loss and improved skeletal muscle mass to body fat ratio, and maintain this loss for at least 1 year. Improved weight loss was associated with more patient visits and longer duration of attendance at the clinic.

Initial outcomes of a dedicated multidisciplinary non‐alcoholic fatty liver disease clinic: a retrospective cohort study

“…This discrepancy may be at least partially explained by variations in service delivery, such as the inclusion of endocrinologists and exercise physiologists in the clinical team, as well as greater provision of weight loss pharmacotherapy and bariatric surgery. Similarly, multidisciplinary weight‐loss and diabetes clinics in Australia have demonstrated weight loss of >5% in excess of 35% of participants 19–21 . These studies report higher usage of pharmacotherapy and the use of exercise physiologists, psychologists, endocrinologists and bariatric surgeons 19–21 .…”

“…Similarly, multidisciplinary weight-loss and diabetes clinics in Australia have demonstrated weight loss of >5% in excess of 35% of participants. [19][20][21] These studies report higher usage of pharmacotherapy and the use of exercise physiologists, psychologists, endocrinologists and bariatric surgeons. [19][20][21] Two clinics offer personalised exercise programmes, and one clinic offers additional group exercise classes supervised by a physiotherapist.…”

“…[19][20][21] These studies report higher usage of pharmacotherapy and the use of exercise physiologists, psychologists, endocrinologists and bariatric surgeons. [19][20][21] Two clinics offer personalised exercise programmes, and one clinic offers additional group exercise classes supervised by a physiotherapist. 20,21 Thus, given a focus of management in our NAFLD clinic includes weight loss, it is important to consider further expansion of our clinic structure and service provision to incorporate a wider range of health professionals and additional interventions, such as a greater usage of pharmacotherapy were appropriate to achieve improved rates of weight loss.…”

The Impact of Multidisciplinary Weight Management on Body Weight and Body Mass Composition in Women with Breast Cancer Post-Adjuvant Chemotherapy: A Retrospective Chart Review

“…There are high levels of concern regarding weight gain after breast cancer; however, prevention and management are hindered by significant gaps in service provision, fatigue associated with disease, and difficulty with maintaining weight [22]. Factors such as a structured exercise regime, prescribed dietary plans, and accountability are significant facilitators to weight management in breast cancer women [22, 38]. Hojan et al [27] investigated the effects of an exercise program in a cohort of premenopausal breast cancer patients undergoing endocrine therapy.…”