Evaluation of the first phase of a specialist weight management programme in the UK National Health Service: prospective cohort study

Objective: To evaluate the first phase of a specialist weight management: programme provided entirely within the UK National Health Service. Design: Prospective cohort study using multiple logistic regression analysis to report odds of >= 5 kg weight loss in all referrals and completers, and odds of completion, with 95% confidence intervals. Anxiety and depression 'caseness' were measured by the Hospital Anxiety and Depression Scale. Setting: Glasgow and Clyde Weight Management Service (GCWMS) is a specialist multidisciplinary service, with clinical psychology support, for patients with BMI >= 35 kg/m(2) or BMI >= 30 kg/m(2) with co-morbidities. Subjects: All patients referred to GCWMS between 2004 and 2006. Results: Of 2976 patients referred to GCWMS, 2156 (72.4%) opted into the service and 809 completed phase 1. Among 809 completers, 35.5% (n 287) lost >= 5 kg. Age >= 40 years, male sex (OR = 1.39, 95% CI 1.05, 1.82), >= 50 kg/m(2) (OR = 1.70, 95% CI 1.14, 2.54) and depression (OR = 1.81, 95% CI 1.35, 2.44) increased the likelihood of losing >= 5 kg. Diabetes mellitus (OR = 0.55, 95% Cl 0.38, 0.81) and socio-economic deprivation were associated with poorer outcomes. Success in patients aged >= 40 years and with BMI >= 50 kg/m(2) was associated with higher completion rates of the programme. Patients from the most deprived areas were less likely to lose >= 5 kg because of non-completion of the programme. Conclusions: Further improvements in overall effectiveness might be achieved through targeting improvements in appropriateness of referrals, retention and effective interventions at specific populations of patients.