A pragmatic randomised controlled trial in primary care of the Camden Weight Loss (CAMWEL) programme — Nanchahal et al. 2 (3) — BMJ Open.
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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/m2 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.