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BMJ Open. 2012 May 4;2(3). pii: e000793. doi: 10.1136/bmjopen-2011-000793. Print 2012.

A pragmatic randomised controlled trial in primary care of the Camden Weight Loss (CAMWEL) programme.

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1
London School of Hygiene & Tropical Medicine, London, UK.

Abstract

OBJECTIVES:

To evaluate effectiveness of a structured one-to-one behaviour change programme on weight loss in obese and overweight individuals.

DESIGN:

Randomised controlled trial.

SETTING:

23 general practices in Camden, London.

PARTICIPANTS:

381 adults with body mass index ≥25 kg/m(2) randomly assigned to intervention (n=191) or control (n=190) group.

INTERVENTIONS:

A structured one-to-one programme, delivered over 14 visits during 12 months by trained advisors in three primary care centres compared with usual care in general practice.

OUTCOME MEASURES:

Changes in weight, per cent body fat, waist circumference, blood pressure and heart rate between baseline and 12 months.

RESULTS:

217/381 (57.0%) participants were assessed at 12 months: missing values were imputed. The difference in mean weight change between the intervention and control groups was not statistically significant (0.70 kg (0.67 to 2.17, p=0.35)), although a higher proportion of the intervention group (32.7%) than the control group (20.4%) lost 5% or more of their baseline weight (OR: 1.80 (1.02 to 3.18, p=0.04)). The intervention group achieved a lower mean heart rate (mean difference 3.68 beats per minute (0.31 to 7.04, p=0.03)) than the control group. Participants in the intervention group reported higher satisfaction and more positive experiences of their care compared with the control group.

CONCLUSIONS:

Although there is no significant difference in mean weight loss between the intervention and control groups, trained non-specialist advisors can deliver a structured programme and achieve clinically beneficial weight loss in some patients in primary care. The intervention group also reported a higher level of satisfaction with the support received. Primary care interventions are unlikely to be sufficient to tackle the obesity epidemic and effective population-wide measures are also necessary.

CLINICAL TRIAL REGISTRATION NUMBER:

Trial registrationClincaltrials.gov NCT00891943.

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