Description and preliminary results from a structured specialist behavioural weight management group intervention: Specialist Lifestyle Management (SLiM) programme

作者:Brown Adrian; Gouldstone Amy; Fox Emily; Field Annmarie; Todd Wendy; Shakher Jayadave; Bellary Srikanth; Teh Ming Ming; Azam Muhammad; John Reggie; Jagielski Alison; Arora Teresa; Thomas G Neil; Taheri Shahrad*
来源:BMJ Open, 2015, 5(4): e007217.
DOI:10.1136/bmjopen-2014-007217

摘要

Background: Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented. Subjects/methods: The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) >= 35 kg/m(2) with comorbidity or >= 40 kg/m(2) without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data. Results: Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m(2)) with 87.2% of patients having a BMI >= 40 kg/m(2) and 12.4% with BMI >= 60 kg/m(2). The mean weight change of all patients enrolled was -4.1 kg (95% CI -3.6 to -4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving -5.5 kg (95% CI -4.2 to -6.2 kg, p=0.0001) and non-completers achieving -2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a >= 5% weight loss. Conclusions: The SLiM programme is an effective group intervention for the management of severe and complex obesity.

  • 出版日期2015