Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

© 2017 Asia Oceania Association for the Study of Obesity Background Finding effective referral policies for weight management services would have important public health implications. Aim Here we compare percentage weight change by referral methods, BMI categories and participants who have had attended weight loss programmes multiple times. Design and settings A prospective cohort study of 15,621 participants referred to 12-week behavioural weight loss programmes funded by the public health service in Birmingham, UK. Methods Comparisons were made between GP versus self-referrals, BMI ≥40 kg/m2–<40 kg/m2 and multiple referrals compared to only one referral. Linear mixed modelling was used to assess percentage weight change after adjusting for covariates. Results Participant's mean age was 48.5 years, 78.7% were of white ethnicity, 90.3% female and mean baseline BMI was 36.3 kg/m2. There were no significant differences in percentage weight loss, between participants that self-referred and those that were referred by their general practitioner (GP) and no significant differences between baseline BMI categories. Referral to a weight loss programme more than once was associated with less weight loss at subsequent attendances (0.92%, 95% CI 0.70–1.14, p < 0.001). Conclusion Allowing self-referral to a weight loss programme widens access without compromising amount of weight lost. These programmes are beneficial for all categories of obesity, including those with a BMI ≥40 kg/m2. Attending weight management programmes more than once results in less weight loss and that swapping to a different program may be advisable.

Original publication




Journal article


Obesity Research and Clinical Practice

Publication Date





709 - 717