Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial

Ahern, Amy L; Breeze, Penny; Fusco, Francesco; Sharp, Stephen J.; Islam, Nazrul; Wheeler, Graham; Hill, Andrew J.; Hughes, Carly A; Duschinsky, Robbie; Thomas, Chloe; Bates, Sarah; Woolston, Jenny; Stubbings, Marie; Whittle, Fiona; Boothby, Clare E.; Bostock, Jennifer; Jebb, Susan; Aveyard, Paul; Boyland, Emma; Halford, Jason C. G.; Morris, Stephen; Brennan, Alan; Griffin, Simon J.

doi:10.1016/s2468-2667(22)00226-2

Cited by 15 publications

(13 citation statements)

References 18 publications

(22 reference statements)

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“…Strong evidence shows that weight gain/regain is common after program end, and this can result in a decline in mental health with participants reporting feelings of failure, blame, and shame [13]. We found that, on average, this behavioral weight management program did not result in long-term increases in depression and anxiety symptoms, despite weight regain [34]. This may provide reassurance to both participants and providers that engaging with a behavioral weight management program is unlikely to have negative long-term impacts on mental health.…”

Section: Discussionmentioning

confidence: 62%

Long‐term impact of a behavioral weight management program on depression and anxiety symptoms: 5‐year follow‐up of the WRAP trial

Jones

Mueller

Sharp

et al. 2022

Obesity

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Objective: Behavioral weight management programs may support short-term mental health; however, limited evidence reports the long-term impacts. This study investigated the impact of behavioral weight management programs on depression and anxiety symptoms at 5 years from baseline. Methods:The Weight loss Referrals for Adults in Primary care (WRAP) trial randomized 1267 adults with BMI ≥ 28 kg/m 2 to a brief intervention (BI) or commercial behavioral weight management program (WW; formerly Weight Watchers) for 12 or 52 weeks (CP12 and CP52, respectively). Linear regression was used to separately compare 5-year changes in depression and anxiety symptoms (by Hospital Anxiety and Depression Scale) between randomized groups, adjusting for baseline depression/anxiety symptoms, gender, and research center.Results: A total of 643 (51%) participants attended the 5-year study follow-up visit.

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Section: Discussionmentioning

confidence: 62%

Long‐term impact of a behavioral weight management program on depression and anxiety symptoms: 5‐year follow‐up of the WRAP trial

Jones

Mueller

Sharp

et al. 2022

Obesity

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“…Physical activity has a key role to play in the management of obesity either by assisting with initial weight loss (in combination with dietary restriction) or by helping to maintain weight loss induced by bariatric surgery and/or pharmacotherapy. Recent evidence demonstrates that behavioural weight management programmes, which include physical activity as a component, can have long-lasting effects (111,112) . Notwithstanding such evidence, some have proposed a 'weight-neutral' strategy for obesity treatment where physical activity is promoted due to a multitude of other benefits aside from effects on weight (113) .…”

Section: Discussionmentioning

confidence: 99%

How can physical activity facilitate a sustainable future? Reducing obesity and chronic disease

Stensel

2023

Proc. Nutr. Soc.

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This review examines the ways in which physical activity can contribute to a sustainable future by addressing significant public health issues. The review begins by identifying obesity and ageing as two major challenges facing societies around the world due to the association of both with the risk of chronic disease. Recent developments in the understanding and treatment of obesity are examined followed by an appraisal of the role of exercise alone and in combination with other therapies in preventing and managing obesity. The review then addresses the interaction between exercise and appetite due to the central role appetite plays in the development of overweight and obesity. The final section of the review examines the potential of physical activity to combat age-related chronic disease risk including CVD, cancer and dementia. It is concluded that while bariatric surgery and pharmacotherapy are the most effective treatments for severe obesity, physical activity has a role to play facilitating and enhancing weight loss in combination with other methods. Where weight/fat reduction via exercise is less than expected this is likely due to metabolic adaptation induced by physiological changes facilitating increased energy intake and decreased energy expenditure. Physical activity has many health benefits independent of weight control including reducing the risk of developing CVD, cancer and dementia and enhancing cognitive function in older adults. Physical activity may also provide resilience for future generations by protecting against the more severe effects of global pandemics and reducing greenhouse gas emissions via active commuting.

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“…Behavioural weight management programmes that support people to reduce their energy intake and increase their physical activity can be an effective intervention for obesity. In one RCT of 1267 participants, those assigned to the 12-week behavioural programme WW® (formally WeightWatchers®) lost 4·8 kg at one-year follow-up [ 10 ] and 2 kg at five-year follow-up [ 11 ]. Furthermore, evidence supports that these programmes are cost-effective in the short and long-term [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Development and initial evaluation of a behavioural intervention to support weight management for people with serious mental illness: an uncontrolled feasibility and acceptability study

2023

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Background The rates of obesity and associated health problems are higher in people with serious mental illness (SMI), such as schizophrenia and bipolar disorder, than the general population. A primary care referral to a behavioural weight management programme can be an effective intervention, but people with SMI have reported barriers to engaging with them and bespoke options are rarely provided in routine practice. It is possible that adjunct support addressing these specific barriers could help. Here we report the development, feasibility and acceptability of an intervention to improve uptake and engagement with a mainstream weight management programme for people with SMI. Methods We worked with people with a lived-experience of SMI and used the person-based approach to develop the ‘Weight cHange for people with sErious mEntal iLlness’ (WHEEL) intervention. It comprised a referral to a mainstream weight management programme (WW®) to be attended once a week, in-person or online, for 12-weeks. The adjunct support comprised a one-off, online consultation called Meet Your Mentor and weekly, telephone or email Mentor Check Ins for 12-weeks. We assessed the feasibility of WHEEL through the number of programme and adjunct support sessions that the participants attended. We analysed the acceptability of WHEEL using a thematic analysis of qualitative interviews conducted at baseline and at 12-week follow-up. Our exploratory outcome of clinical effectiveness was self-reported weight at baseline and at end-of-programme. Results Twenty participants were assessed for eligibility and 17 enrolled. All 17 participants attended Meet Your Mentor and one was lost to follow-up (94% retention). Nine out of 16 attended ≥50% of the weekly programme sessions and 12/16 attended ≥50% of the weekly check-ins. Participants reported in the interviews that the adjunct support helped to establish and maintain a therapeutic alliance. While some participants valued the in-person sessions, others reported that they preferred the online sessions because it removed a fear of social situations, which was a barrier for some participants. The mean change in self-reported weight was − 4·1 kg (SD: 3·2) at 12-weeks. Conclusions A mainstream weight management programme augmented with brief and targeted education and low-intensity check-ins generated sufficient engagement and acceptability to warrant a future trial.

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Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial

Cited by 15 publications

References 18 publications

Long‐term impact of a behavioral weight management program on depression and anxiety symptoms: 5‐year follow‐up of the WRAP trial

Long‐term impact of a behavioral weight management program on depression and anxiety symptoms: 5‐year follow‐up of the WRAP trial

How can physical activity facilitate a sustainable future? Reducing obesity and chronic disease

Development and initial evaluation of a behavioural intervention to support weight management for people with serious mental illness: an uncontrolled feasibility and acceptability study

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