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Tier 3 specialist weight management service and pre-bariatric multicomponent weight management programmes for adults with obesity living in the UK: a systemic review

Alkharaiji, Mohammed; Anyanwagu, Uchenna; Donnelly, Richard; Idris, Iskandar

Tier 3 specialist weight management service and pre-bariatric multicomponent weight management programmes for adults with obesity living in the UK: a systemic review Thumbnail


Authors

Mohammed Alkharaiji

Uchenna Anyanwagu

Richard Donnelly

ISKANDAR IDRIS Iskandar.Idris@nottingham.ac.uk
Professor of Diabetes and Metabolic Medicine



Abstract

Background: NHS England has recommended a multidisciplinary weight management services (MWMS -Tier 3 services) for patients requiring specialised management of obesity, including bariatric surgery, but clinical and measurable health-related outcomes from these services remains fragmented. We therefore undertook a systematic review to explore the evidence base of effect on body weight loss and comorbidities outcomes of Tier 3 or UK pre-bariatric MWMPs.
Methods: AMED, CINAHL, EMBASE, HMIC, MEDLINE, PsycINFO, PubMed, HDAS search and Google Scholar were searched from January 2000 to September 2017 in a free-text fashion and crossed-references of included studies to identify potential illegibility. Inclusion criteria were: a) published Tier 3 original study abstracts/articles; b) intervention studies with before-and-after data; c) studies that included any sort of MWMPs conducted on British residents with obesity; and, d) studies included T2DM measurements in a MWMPs.
outcomes from these services remains fragmented. We therefore undertook a systematic review to explore the evidence base of effect on body weight loss and comorbidities outcomes of Tier 3 or UK pre-bariatric MWMPs.
Methods: AMED, CINAHL, EMBASE, HMIC, MEDLINE, PsycINFO, PubMed, HDAS search and Google Scholar were searched from January 2000 to September 2017 in a free-text fashion and crossed-references of included studies to identify potential illegibility. Inclusion criteria were: a) published Tier 3 original study abstracts/articles; b) intervention studies with before-and-after data; c) studies that included any sort of MWMPs conducted on British residents with obesity; and, d) studies included T2DM measurements in a MWMPs.
Results: In total, 19 studies met the inclusion criteria. The total number of participants analysed was N=11,735. Baseline accumulative average BMI was calculated at 42.54 kg/m2, weight 117.88 kg and waist circumference 126.9 cm. And at 6 months, 40.73 kg/m2, 112.17 kg and 120.3 cm; respectively. Secondary outcome variables were as improved with reduction in HbA1c, fasting blood sugars, insulin usage and blood pressure. Physical activity increased at 3 months then declined after 6 months with no significant changes in cholesterol levels.
Conclusion: Tier 3 and MWMPs have a short to mid-ranged positive effect on obese patients (BMI ≥30 kg/m2) living in the UK regarding accumulated reduction in weight, glycaemic control, blood pressure and with subtle improvements in physical activity.

Citation

Alkharaiji, M., Anyanwagu, U., Donnelly, R., & Idris, I. (2019). Tier 3 specialist weight management service and pre-bariatric multicomponent weight management programmes for adults with obesity living in the UK: a systemic review. Endocrinology, Diabetes and Metabolism, 2(1), Article e00042. https://doi.org/10.1002/edm2.42

Journal Article Type Article
Acceptance Date Sep 9, 2018
Online Publication Date Oct 25, 2018
Publication Date 2019-01
Deposit Date Sep 13, 2018
Publicly Available Date Mar 29, 2024
Journal Endocrinology, Diabetes and Metabolism
Electronic ISSN 2398-9238
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 2
Issue 1
Article Number e00042
DOI https://doi.org/10.1002/edm2.42
Public URL https://nottingham-repository.worktribe.com/output/1073899
Publisher URL https://onlinelibrary.wiley.com/doi/full/10.1002/edm2.42