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Obesity

Interventions to treat adult obesity

Obesity is a major risk factor for developing type 2 diabetes, cardiovascular disease, some cancers, and other health conditions. Intervening to support people to lose weight can reduce the risk of these conditions. We have worked with and through the health system to develop and test low cost and high reach programmes to meet the scale of the challenge of obesity.

We have shown that GPs can intervene opportunistically to raise the topic of weight in a consultation unrelated to that. This intervention, which can be delivered in 30 seconds, was shown to lead to greater weight loss, be highly acceptable to patients, and be cost saving for the NHS. Likewise, we have shown that interventions delivered by low-cost programmes led by non-specialists lead to greater weight loss than people’s own unguided efforts and providing these programmes is cost-saving for the NHS.

We have also begun to test more complex and more expensive treatments for obesity, including total diet replacement, bariatric surgery, and pharmacotherapy. We aim to optimise effectiveness and cost-effectiveness by assessing their use in combined programmes.

Despite these findings, clinicians remain reluctant to engage with treating obesity in their patients. We have sought to understand these concerns and address them in our programmes.

Here are some examples of our work in this area:

  • BWeL: A trial testing the effectiveness of brief opportunistic weight loss interventions by GPs
  • WRAP: A trial testing the effectiveness of referral to commercial weight management services and the optimum length of the referral
  • DROPLET: A trial testing the effectiveness of GP referral to a low energy total diet replacement programme
  • NewDawn: a project to develop a new care pathway for people with newly diagnosed type 2 diabetes to help them achieve remission.
  • LiFT and LIFT2: two trials showing the safety and effectiveness of severe energy restriction in people with metabolic dysfunction-associated steatotic liver disease
  • ARIADNE: A trial showing that intensive weight loss support is effective in improving eating disorder symptoms in people at high risk of eating disorders.
  • PREVAIL Trial: People regulating themselves to achieve weight loss
  • ARTEMIS: A digital intervention based on self-regulation for weight loss