Background: Multidisciplinary care is well recognised as being effective for weight and chronic disease management, and in weight loss maintenance. However, in the Australian context, there are inadequate obesity services. In recognising this health service gap, this led to the establishment of the privately funded university hospital-based weight management clinic the Healthy Weight Clinic to increase access to multidisciplinary services. The effectiveness of the clinic in supporting patients to achieve clinically significant weight loss (at least 510% weight reduction) and weight loss maintenance was evaluated.
Methods: A retrospective chart review was conducted to determine weight outcomes from patients who attended an initial consultation March 2017 March 2019, with follow up data until June 2020 extracted. Patients received one-on-one multidisciplinary care, including endocrinological input for medical and co-morbidity identification and management, lifestyle behavioural counselling from a dietitian and exercise physiologist, with adjunctive pharmacotherapy used in 81.4% patients.
Results: 172 patients received more than one follow-up consultation for lifestyle modification, and mean final weight change was -6.2 kg (range -42.0 kg to 10.4 kg; SD 7.4). This equated to a mean percentage weight change of -5.8% (range -41.6% to 10.7%; SD 6.9). Weight loss of ≥5% of initial body weight was observed in 49.4% of patients (n=85/172) and 27.3% (n=47/172) achieved between 5 and 9.9% weight loss. At 12 months, mean weight change was -9.2 kg (SD 7.5), -9.7 kg (SD 5.8) at 24 months and -12.6 kg (SD 25.5) at 36 months. Twenty percent of patients (n=35/172) maintained ≥5% of initial body weight loss for at least one year. Weight regain from baseline occurred in 10.5% of patients (n=18/172).
Conclusions: When receiving support in a structured dedicated holistic obesity service, patients can achieve clinically meaningful weight loss and maintain this loss. One in five patients could maintain this weight loss, which was potentially confounded by COVID-19 period influences on lifestyle habits. Atlantis, E. et al. Clinical Obesity Services in Public Hospitals in Australia: a position statement based on expert consensus. Clinical Obesity 8, 203-210, doi:10.1111/cob.12249 (2018). Wing R, Hill J. Successful weight loss maintenance. Ann Rev Nutr 21, 323-341, doi:10.1146/annurev.nutr.21.1.323 (2001).
30 Jun 2021 - 01 Jul 2021