Background: Obesity is a global epidemic causing significant burdens on the health systems and economic productivity of most countries. In Australia it is estimated that 66% of the population is overweight or obese, similar to rates in the UK. The multidisciplinary approach to weight management has been developed in response to the growing demand for effective, evidence-based weight management services for people with complex health care requirements. This approach aims to facilitate weight loss with long-term weight maintenance and improvements in health risk-factors. A Sydney based multidisciplinary weight management clinic based on this principle was developed, employing endocrinology, dietetics, exercise physiology, psychology, and bariatric surgical domains.
Aim: To evaluate the effectiveness of a Sydney based multidisciplinary weight management clinic for patients receiving pharmacotherapy and lifestyle interventions between March 2017 and April 2019.
Methods: A retrospective chart review of 166 patients was conducted to evaluate change in; weight, BMI, excess weight lost (EWL), total body weight lost (TWL), reversal of clinical indicators for co-morbidities, change in body composition measures, HbA1c, total cholesterol, and triglycerides.
Results: 84.3% (n=140) of patients lost a statistically significant amount at each of the time points and weight loss was durable (P<0.0001). Patients lost on average; −5.1 kg (−25.1 to +3.5 kg) (P<0.0001) between baseline and 3 months; −2.5 kg (−10.0 to +3.6 kg) (P<0.0001) between 3 and 6 months; −1.3 kg (−8 to +2 kg) (P=0.0449) between 6 and 9 months. Patients lost a mean of; −7.20 kg (−31 to −0.1 kg), 24.55% (−245.50 to −0.66%) EWL, −6.68% (−21.68 to −0.12%) TWL. 44 patients dropped at least one BMI class, which was statistically significant (P-value<0.0001), 2 patients dropped 2 BMI classes. In addition, 53.61% of patients achieved >=5% TWL. 64 patients reached between 5 and 9.9% TWL, 12 patients reached between 10 and 14.9% TWL, and 13 achieved >=15% TWL. Further follow up of this cohort is ongoing. After intervention many patients resolved clinical indications of metabolic co-morbidities; pre-diabetes (n=10), dyslipidaemia (n=3), NAFLD (n=5), and hypertension (n=3).
Conclusions: Through integrated multidisciplinary care patients achieved statistically and clinically significant weight loss, with improvements in co-morbidities. This demonstrates that real world multidisciplinary approaches to weight management can result in durable, clinically meaningful weight loss.