Description and preliminary results from a structured specialist behavioural weight management group intervention: Specialist Lifestyle Management (SLiM) programme

Adrian Brown, Amy Gouldstone, Emily Fox, Annmarie Field, Wendy Todd, Jayadave Shakher, Srikanth Bellary, Ming Ming Teh, Muhammad Azam, Reggie John, Alison Jagielski, Teresa Arora, G. Neil Thomas, Shahrad Taheri

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Abstract

Background: Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented. Subjects/methods: The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35 kg/m2 with comorbidity or ≥40 kg/m2 without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data. Results: Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m2) with 87.2% of patients having a BMI≥40 kg/m2 and 12.4% with BMI≥60 kg/m2. The mean weight change of all patients enrolled was -4.1 kg (95% CI -3.6 to -4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving -5.5 kg (95% CI -4.2 to -6.2 kg, p=0.0001) and non-completers achieving -2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss. Conclusions: The SLiM programme is an effective group intervention for the management of severe and complex obesity.

Original languageEnglish
Article numbere007217
JournalBMJ Open
Volume5
Issue number4
DOIs
Publication statusPublished - 2015

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ASJC Scopus subject areas

  • Medicine(all)

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Brown, A., Gouldstone, A., Fox, E., Field, A., Todd, W., Shakher, J., Bellary, S., Teh, M. M., Azam, M., John, R., Jagielski, A., Arora, T., Thomas, G. N., & Taheri, S. (2015). Description and preliminary results from a structured specialist behavioural weight management group intervention: Specialist Lifestyle Management (SLiM) programme. BMJ Open, 5(4), [e007217]. https://doi.org/10.1136/bmjopen-2014-007217