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Background and study aims About 42% men and 32% women in England are overweight [body mass index (BMI) 25 kg/m2 or over] and some 24% are obese (BMI 30 kg/m2 or over). The prevalence (percentage of a population affected at a given time) of obesity has increased and is expected to rise further. Ill health resulting from obesity is responsible for about 10% of morbidity and mortality in the UK and costs the NHS about 7 billion pounds annually. Obesity is associated with a number of adverse health conditions including cardiovascular disease, Type 2 diabetes, osteoarthritis and a number of cancers. Weight loss has been shown to improve many of these illnesses, and reduce the risk of early death. An increasing number of people are in need of interventions (treatment) to help them to lose weight. General Practitioners (GPs) are encouraged to measure BMI and monitor patients with a BMI of 30 kg/m2 or greater. Such patients are expected to be recommended healthy eating and physical activity, and to receive drug therapy and/or a referral to a practice nurse or dietician, if indicated. Current treatments have modest effects which can be beneficial, but are likely to be lost once the medication is stopped. Surgical interventions are more successful but are currently expensive and unsuitable for large scale use. Dietary interventions on their own have only uncertain effects and brief routine interventions within primary care have generally reported disappointing results. More intensive behavioural interventions generate a small but sustainable weight loss, which can have significant and clinically worthwhile long term health benefits. Such interventions however are normally limited to commercial or research context. Weight management in overweight individuals who seek help normally requires changes to their habitual lifestyle which are difficult to implement and maintain without specialist input, structure and support. The Weight Action Programme (WAP) is a weight loss intervention that was developed over several years through client feedback and testing in deprived communities. It provides people with tools to maintain a healthy lifestyle, with weekly individualized tasks, and peer support group sessions. The proposed study has been designed to establish whether WAP maintains its effects long term, and whether it helps people more than current best practice GP advice. Who can participate? Participants (330 overweight adults) will be referred from general practice. What does the study involve? Particpants will be randomly assigned to WAP or to a session with a trained nurse who will provide weight management advice modelled on the current best practice in primary care. The WAP will provide weekly sessions for 8 weeks, followed by monthly maintenance sessions for one year. The nurse will provide an initial 20 - 30 minute intervention followed by three further sessions over 8 weeks, accompanied by standard written materials and referrals to local physical activity programmes. Both the WAP and the nurse appointments will be run from GP surgeries. Weight loss over one year will be measured. Other measures concerning the participant’s health, exercise levels, and health behaviours will also be collected. What are the possible benefits and risks of participating? The main benefit to the participant is the chance to try a safe treatment that could enhance the likelihood of achieving and maintaining a beneficial weight loss. We do not forsee any potential risks to participants. Where is the study run from? The study is being conducted by researchers from Queen Mary University of London which includes experts who have extensive experience in developing and testing interventions to help people change their health behaviours. When is the study starting and how long is it expected to run for? The study recruitment started in September 2012 and recruitment is expected to finish in March 2014. Who is funding the study The study is being funded by the National Institute for Health Research - Health Technology Assessment Programme (NIHR-HTA). Who is the main contact? Dr Hayden McRobbie [email protected]

Inclusion criteria

• Obesity/weight management

Links

• ictrp
• isrctn