Introduction: Specialist weight management service provides an effective treatment option for severe obesity; however, there is limited data is exploring the baseline predictors of response and effect on HbA1c following engagement with the service.
Methods: We used prospective data from the regional weight management Tier 3 weight management services within the Hull and East Yorkshire NHS Tier 3 Obesity Programme. Data were available for 249 patients referred to the service. T-tests were used for univariate baseline characteristics of those with and without 5% weight loss after engagement with the service. Logistic regression analysis was used to identify independent predictors of weight loss at 12 months.
Results: Three hundred three patients were referred to the Tier 3 adult weight management service, of which 249 (83%) patients participated in the program and had at least one follow-up. The median age of the study population was 46 (3655) and consisted of 66% females with a median baseline BMI of 44 (4245). The prevalence of Type 2 diabetes was 31%, hypertension was 34%, GORD was 34%, and osteoarthritis was 29%. The median baseline weight on enrolment in the program was 126 (115138). During the follow-up period of 1 year, the median weight dropped to 120.5 kg at three months, 119.6 kg at six months, 117.7 kg at nine months and 117.5 kg at 12 months. The median HbA1c dropped from a baseline of 60.25 to 54.4 mmol/mol during the follow-up period. Sixty-four patients had baseline HbA1c of >53 mmol/mol (7% HbA1c) of which 21% had a dropped below 53 (7% HbA1c) mmol/mol in follow-up. In the logistic regression model higher age (OR =1.05, P-value= 0.0001) Type 2 Diabetes (OR= 2.54 P-value=0.00) and dyslipidaemia (OR=2.21 P=0.03) were independently associated with more than 5% weight loss at 12 months follow-up.
Conclusion: Engagement with Tier 3 adult weight management is associated with significant weight loss and improvement in glycaemic control in a large proportion of patients. Higher age, diabetes and dyslipidaemia at baseline are independent predictors of weight loss on Tier 3 weight management service.