Background: Obesity is a major and increasing problem in Australia, despite many strategies in place to prevent and reverse it. We developed a new model of weight loss clinic in general practice that uses multidisciplinary approach in group sessions.
Method: Patients of two general practices were recruited via waiting room pamphlets; referral by GPs within the clinic; invitation letter sent to patient ≥18 years old and BMI≥30kg/m2 or prescribed Phentermine within the previous 12 months. Twelve 8-week programs were conducted by a team comprising a GP, practice nurse, lifestyle adviser, dietician, exercise physiologist and psychologist. Patients learn to identify and establish key health habits in a series of weekly educational meetings. Eating and physical activity behaviours were recorded in a diary and patients attended weekly consultation with the GP where their progress was monitored by measurement with bioelectrical impedance scales. Clinic reminders and motivational text messages were sent between meetings. The program was funded without out-of-pocket cost to participants by bulkbilling under Medicare item numbers and by donation of allied health professional time.
Results: Between October 2011 and July 2014, 278 patients were completed twelve 8-week weight loss programs. Their median age was 47 years (range from 18-75) and the majority (84%) were female. At baseline, median BMI was 34.4kg/m2 (range 23.7-63.9), body weight 92.7kg (60.3-169.9), estimated body fat percentage 42% (25-58) and waist circumference 105 cm (74-153). Median changes from baseline of BMI, weight (kg), estimated body fat (%) and waist circumference (cm) were (-0.7,-2,-1.6,-4) at 8 weeks and (-1.1, -2.6, -2.2,-4) at 6 months accordingly. At 8 week evaluation, a large proportion was able to reach their goals, including weight loss (63%) and establishing new behaviours (84%).
Discussion: The decreases in weight, body fat and waist circumference achieved via our multidisciplinary group clinic model are encouraging. The longer term efficacy and generalisabilty of this model deserves further study, and we are following up all groups.