A randomised controlled trial to test the effectiveness of a brief intervention for weight management for obese adults in primary care.

Lead Research Organisation: University of Oxford
Department Name: Primary Care Health Sciences

Abstract

Obesity, a major cause of chronic disease, affects 25% of adults. Even a small loss of weight is likely to reduce the risk of chronic diseases occurring, such as diabetes that are the consequence of being overweight. We can use lessons learnt from tobacco control and apply these to obesity. GPs make unsolicited brief interventions frequently on smoking and problem drinking, which are known to be effective in changing patients' behaviour. A key aim of the smoking cessation brief interventions is to refer patients to the NHS Stop Smoking Service, which treated 750,000 people last year in England. Available data suggest GPs rarely bring up weight issues opportunistically and do not know what they could say that would be helpful. Available data also suggest patients who are overweight would like more advice on this from their doctors.

Recent evidence has shown that attending a commercial weight management service, such as Weight Watchers, is more effective than any other widely available alternative weight loss intervention in primary care. In England, referral to commercial weight management is available free to patients on the NHS voucher scheme or equivalent.

We therefore propose a trial in which GPs will bring up the issue of weight with patients presenting to their GP for reasons other than weight management. Patients will be randomised to one of two interventions. In the control group, the GP will encourage weight loss because this will benefit health. In the intervention group, GPs will advocate referral to a weight management service and make that referral immediately. They will also offer a review about a month later to check progress. The main outcome will be weight loss at one year, but we will also record participants' and GPs' reactions to both types of interventions.

The trial results could make the case for brief interventions for obese people consulting their GP and introduce widespread simple treatments akin to the effective NHS Stop Smoking Service. The intervention makes only very modest demands on a GP's time and skills. If successful and implemented widely, it will increase a GP's engagement with weight loss and maintenance. Likewise, the intervention could be introduced into the GP pay for performance scheme and could influence practice worldwide.

Technical Summary

Obesity affects 25% of the UK's adult population but modest weight loss can reduce the incidence of obesity-related chronic disease. Some effective weight loss treatments exist but there is no nationally available NHS treatment service and GPs rarely discuss weight management with patients or support behaviour change. Evidence shows that commercial weight management services, that most PCTs have 'on prescription', are more effective than primary care treatment. We propose a controlled trial where patients will be randomised to receive either the offer of help by referral to a weight management service and follow-up to assess progress or advice to lose weight on medical grounds. The primary outcome will be weight change at 12-months. Other questions are: What actions do people take to manage their weight in response to the two GP intervention types? How do obese patients feel about GPs opportunistically discussing weight management and how does this vary by intervention type? How do GPs feel about raising the issue opportunistically and giving the two types of brief intervention? What is the cost per kg/m2 lost for each intervention? Research assistants visiting GP practices in the West Midlands (n=60) would objectively measure weight and height prior to GP consultations and randomise willing patients (BMI 30+, 18+ years) using sealed envelopes. Full recruitment (n=1824) is feasible in 46 weeks, requiring 6 sessions of advice-giving per GP. Participants will be contacted at 3-months (post intervention) via telephone, to identify actions they have taken to manage their weight. We will book appointments for participants to be seen at their GP practice for a 12-month follow-up. Trial results could make the case for brief interventions for obese people consulting their GP and introduce widespread simple treatments akin to the NHS Stop Smoking Service. Likewise, the intervention could be introduced in the Quality and Outcomes Framework and influence practice worldwide.

Planned Impact

The key non-academic beneficiaries are obese people with weight problems consulting their doctor, doctors, future commissioners of public health interventions, such as Public Health England and GP consortia, the National Institute of Health and Clinical Excellence (NICE) (who oversee recommendations on health policy), the Department of Health, and providers of weight loss services.

People with weight problems report that they want their doctor to discuss this issue and help them manage their weight, but the available evidence suggests that doctors do this infrequently. Furthermore, interventions are generally focused on advice to lose weight, not on effective interventions. Should this intervention prove effective, this could lead to relatively rapid changes in clinical practice that will change the experience for patients. Currently most interventions doctors make focus on the consequences of obesity, such as treating hypertension or diabetes, where some treatments make weight loss harder. The results of this trial could introduce preventative medical action before people develop the complications of obesity, which people say that they want.

Doctors report a lack of knowledge and a corresponding lack of confidence in managing obesity. Although our research does not directly tackle this, depending on the results, it could provide doctors with an evidence-based management strategy that would increase their confidence to discuss weight issues with their patients.

Policy makers, represented by NICE and the various UK health departments are direct beneficiaries and hold the key to implementing the results of this research. NICE has published guidelines on the identification and management of obesity and is also responsible for the Quality and Outcomes Framework (QOF) for GPs. The QOF currently rewards GPs for identifying obesity but not for any active management, unlike all other clinical areas, reflecting the gap in evidence that our trial would fill. Through our contacts with the NICE QOF process and because NICE guidelines are updated regularly, we believe that implementation of the results of this research will follow shortly after publication, if the results are positive.

Providers of weight loss services may benefit from the study findings if positive, because they would encourage doctors to refer to these services. It will be a decision for the NHS whether they wish to engage with any willing provider, the current policy, or develop its own NHS weight management services. These providers generate jobs and tax revenue within the UK.

The researchers will benefit. Amanda Lewis is a newly appointed post-doctoral worker and will work as co-PI alongside Paul Aveyard and other senior members of the investigator team, who are experienced in running trials in primary care. In so-doing, she will develop skills and experience that will allow her to develop as an independent researcher. We will also appoint a trial manager and it is our aspiration that s/he would register for a part-time PhD to use the data from the trial. In doing so, s/he would train in a UKCRC centre of excellence in public health research with a growing team of researchers in behavioural medicine. The link with the MRC Centre for Human Nutrition Research that this application embodies will also link with another UKCRC centre of excellence and a broader range of research on weight management.

More broadly, there are gains from prevention, such as reducing sickness absence, reduced health care costs, and improved health and quality of life.

Publications

10 25 50
 
Description Briefing for DH Permanent Secretary
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
Impact Informed development of government obesity strategy
 
Description Calorie Reduction Advisory Group
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Chair NICE Committee: Sexually transmitted infections: condom distribution schemes (NG68)
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Chair NICE Committee: Vitamin D: supplement use in specific population groups (PH56)
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Consultation on calorie labelling for food and drink served outside of the home
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Developing PHE guidelines
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
URL https://www.gov.uk/government/publications/adult-weight-management-a-guide-to-brief-interventions
 
Description Discussion with chief civil servant at Department of Health
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Evidence synthesis and report to NICE to inform guidance
Geographic Reach National 
Policy Influence Type Membership of a guidance committee
Impact Our systematic reviews were described as 'the best ever' by NICE and led to guidance on the management of obesity which are likely to have important though unmeasurable impacts on patient care
URL http://www.nice.org.uk/guidance/ph53
 
Description Input into weight management components of NHS Long Term Plan
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
Impact NHS has committed to a pilot project of Total Diet Replacement Programmes for people with diabetes based in part on our research NHS has committed to expansion of behavioural weight management services for people with diabetes and hypertension, based in part on our research
 
Guideline Title Weight management: lifestyle services for overweight or obese adults NICE guidelines [PH53]
Description NICE guidance on lifestyle weight management
Geographic Reach National 
Policy Influence Type Citation in clinical guidelines
Impact We conducted systematic reviews of the effects of interventions in primary care for weight loss, weight loss maintenance, and the barriers and facilitators to these.
URL https://www.nice.org.uk/guidance/ph53
 
Description National Diabetes Prevention programme Advisory Group
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
Impact Design of the National Diabetes Prevention programme and oversight/guidance during implementation
 
Description No 10 Round-table on obesity
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
Impact Discussions informed development of obesity strategy
 
Description PHE Obesity Priority Programme Board
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
Impact Advice on the implementation of the national obesity strategy/plan
 
Description Presentation: 'Policy initiatives to tackle obesity in England' - Australian Government Obesity Summit
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a advisory committee
 
Description Presentation: Obesity policy in England - NSW Treasury
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a advisory committee
 
Description Response to draft NICE guidance
Geographic Reach National 
Policy Influence Type Gave evidence to a government review
Impact Draft NICE guidance on 'lifestyle weight management' was based on our guidance but went way beyond the evidence in many respects in our team's view. In particular, the guidance was drafted in a way that seemed to emphasise the difficulties of practitioners talking to patients about being overweight. We drafted a response and talked to the director of PH guidance, Mike Kelly, that tackled this and the guidance was amended significantly. In addition, we were able to advise NICE to introduce standards as to the way that these services were delivered.
URL http://www.nice.org.uk/guidance/ph53
 
Description The Queen's Lecture for the British Council - Berlin: Government initiatives to tackle obesity
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a advisory committee
 
Description A programme of research on weight management in obesity
Amount £249,832 (GBP)
Organisation National Institute for Health Research 
Department School for Primary Care Research
Sector Academic/University
Country United Kingdom
Start 09/2010 
End 08/2013
 
Description A randomised controlled trial to compare teh clinical effectivensss of referring patients to the Cambridge Wight Plan compared with usual care for weight management: DROPLET
Amount £740,000 (GBP)
Organisation Cambridge Weight Plan 
Sector Private
Country United Kingdom
Start 01/2015 
End 12/2017
 
Description A randomised controlled trial to compare the clinical effectiveness of referring patients to the Cambridge Weight Plan compared with usual care for weight management.
Amount £740,000 (GBP)
Organisation Cambridge Weight Plan 
Sector Private
Country United Kingdom
Start 09/2015 
End 08/2018
 
Description An analysis of the cost effectiveness of referring patients to the Cambridge Weight Plan compared with usual care for weight management. DROPLET
Amount £30,000 (GBP)
Organisation Cambridge Weight Plan 
Sector Private
Country United Kingdom
Start 01/2019 
End 09/2019
 
Description BWeL studentship
Amount £65,000 (GBP)
Organisation National Institute for Health Research 
Department School for Primary Care Research
Sector Academic/University
Country United Kingdom
Start 10/2016 
End 09/2019
 
Description Development and feasibility testing of an intervention to support people to lose weight through daily weighing
Amount £33,796 (GEL)
Organisation University of Cambridge 
Department Wolfson College
Sector Academic/University
Country United Kingdom
Start 10/2016 
End 09/2019
 
Description Development and feasibility testing of an intervention to support people to lose weight through daily weighing
Amount £82,652 (GBP)
Funding ID P2-603 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 10/2016 
End 09/2019
 
Description Feasibility and acceptability of a brief routine weight management intervention for postnatal women embedded within the national child immunisation programme in primary care: randomised controlled trial and nested qualitative study
Amount £326,039 (GBP)
Funding ID HTA/15/184/14 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 09/2017 
End 02/2019
 
Description NIHR Biomedical Research Centre- theme on Diet and Obesity
Amount £4,500,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 04/2017 
End 03/2022
 
Description Obesity, Diet & Lifestyle Theme
Amount £4,500,000 (GBP)
Organisation Oxford University Hospitals NHS Foundation Trust 
Department NIHR Oxford Biomedical Research Centre
Sector Public
Country United Kingdom
Start 04/2017 
End 03/2022
 
Description Raising the topic of smoking cessation in general practice: a conversation analysis of GP consultations on smoking
Amount £55,917 (GBP)
Organisation Cancer Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start 09/2017 
End 08/2019
 
Title GP training materials 
Description The research team have developed an online training course for GPs about how to deal with weight management and deliver brief opportunistic interventions to suitable patients. 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact We will not know the notable impacts until the end of the trial. However if successful we plan to adapt the materials and roll it on on a national basis for GPs. The training for the trial can easily be edited to provide a training course that can be implemented immediately. 
 
Title Nurse training 
Description The research team have developed a training programme for nurses on how to accurately calculate BMI and use this, together with body fat percentage, to identify patients who are obese and at risk of health problems. 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact This method has given nurses greater confidence in approaching the issue of obesity with their patients 
 
Description Collaboration with Glasgow and Leicester universities 
Organisation University of Glasgow
Country United Kingdom 
Sector Academic/University 
PI Contribution Based on this trial, we have been asked to collaborate on a grant application to BHF to test the effect of weight loss interventions prior to cardiac surgery. It is our experience of engaging a high proportion of people with the weight loss intervention that led to this collaboration.
Collaborator Contribution We are developing a grant application
Impact Not yet submitted
Start Year 2018
 
Description Collaboration with Glasgow and Leicester universities 
Organisation University of Leicester
Country United Kingdom 
Sector Academic/University 
PI Contribution Based on this trial, we have been asked to collaborate on a grant application to BHF to test the effect of weight loss interventions prior to cardiac surgery. It is our experience of engaging a high proportion of people with the weight loss intervention that led to this collaboration.
Collaborator Contribution We are developing a grant application
Impact Not yet submitted
Start Year 2018
 
Description Coventry University 
Organisation Coventry University
Country United Kingdom 
Sector Academic/University 
PI Contribution The research team has taken the lead in designing and getting the trial up and running. We also manage the trial on a daily basis and are responsible for publication and dissemination of results.
Collaborator Contribution Dr Deborah Lycett contributed to this trial from the planning stages and continue to provide support to the trial in a number of capacities.
Impact The output is the trial itself
Start Year 2010
 
Description MRC Cambridge 
Organisation Medical Research Council (MRC)
Department MRC Human Nutrition Research Unit
Country United Kingdom 
Sector Public 
PI Contribution The research team has taken the lead in designing and getting the trial up and running. We also manage the trial on a daily basis and are responsible for publication and dissemination of results.
Collaborator Contribution Professor Susan Jebb provides intellectual input for the trial; she has done so from the planning stages and continues to provide support to the trial. She brings expertise surrounding weight management in primary care. The collaboration with the MRC unit ended in 2013 due to Prof Susan Jebb taking up a position at University of Oxford.
Impact The output is the trial.
Start Year 2010
 
Description RCGP 
Organisation Royal College of General Practitioners
Country United Kingdom 
Sector Academic/University 
PI Contribution The research team has taken the lead in designing and getting the trial up and running. We also manage the trial on a daily basis and are responsible for publication and dissemination of results.
Collaborator Contribution Dr Rachel Pryke from RCGP assisted with the training materials for the GPs. She is the obesity champion for the RCGP.
Impact The training material for the GPs is the output of this collaboration.
Start Year 2012
 
Description Rosemary Conley 
Organisation Rosemary Conley Diet and Fitness Clubs
Country United Kingdom 
Sector Private 
PI Contribution The research team has taken the lead in designing and getting the trial up and running. We also manage the trial on a daily basis and are responsible for publication and dissemination of results.
Collaborator Contribution Rosemary Conley have provided support for the treatment costs of the trial and some of their class providers have offered to give classes for free to our participants.
Impact There are no outputs yet.
Start Year 2011
 
Description Slimming World 
Organisation Slimming World
Department Research Development
Country United Kingdom 
Sector Private 
PI Contribution The research team has taken the lead in designing and getting the trial up and running. We also manage the trial on a daily basis and are responsible for publication and dissemination of results.
Collaborator Contribution Slimming world offered to cover the treatment costs for the trial and provided, for free, the vouchers for our participants to attend Slimming World.
Impact There are no outputs yet.
Start Year 2010
 
Description University of Birmingham 
Organisation University of Birmingham
Department Department of Primary Care Clinical Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution The research team has taken the lead in designing and getting the trial up and running. We also manage the trial on a daily basis and are responsible for publication and dissemination of results.
Collaborator Contribution Dr Amanda Farley, Dr Amanda Daley, Prof Kate Jolly And Dr Peymane Adab all contributed to this trial from the planning stages and continue to provide support to the trial in a number of capacities, such as intellectual input and trial support.
Impact The outcome from this partnership is the trial itself.
Start Year 2010
 
Description University of Oxford 
Organisation University of Oxford
Department Oxford Clinical Trials Unit (CTU)
Country United Kingdom 
Sector Academic/University 
PI Contribution The research team has taken the lead in designing and getting the trial up and running. We also manage the trial on a daily basis and are responsible for publication and dissemination of results.
Collaborator Contribution They have helped to get the trial sponsored and support the research team to run the trial on a daily basis. (The trial relocated from Birmingham to Oxford in Sept 2012, hence the later start date).
Impact The trial is the output for this collaboration.
Start Year 2012
 
Title Brief Intervention for Weight Loss 
Description We have developed a public health intervention aimed at obese patients to assist with weight management in primary care. We have trained GPs to offer patients either advice on why they should lose weight on medical grounds or support to lose weight with the offer of a referral to a commercial weight management service. This intervention is delivered using a brief opportunistic approach that lasts about 30 seconds and is to be delivered at the end of a normal consultation when someone has visited for something other than weight management. 
Type Management of Diseases and Conditions
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2013
Development Status Under active development/distribution
Clinical Trial? Yes
Impact We won't know the notable impact until the trial has finished. 
URL http://www.controlled-trials.com/ISRCTN26563137
 
Description Appearance on Radio 4 Inside Health 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact This was a feature of about 5 minutes on Inside Health, a popular Radio 4 programme, majoring on brief interventions by GPs
Year(s) Of Engagement Activity 2015
URL http://www.bbc.co.uk/programmes/b03zy4hs
 
Description Association for the Study of Obesity Annual Meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation of a series of studies including two NPRI funded projects about weight management in primary care.
Year(s) Of Engagement Activity 2016
 
Description BBC World Service Nutrition Series 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Series of short interviews on variety of nutrition topics
Year(s) Of Engagement Activity 2016
 
Description Cambridge Science Festival 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Short presentation and extended Q&A about aetiology and management of obesity, based on BBC series
Year(s) Of Engagement Activity 2015
 
Description Department open day 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Our team put on activities and displays to improve awareness of obesity and its health consequences, food energy, and the issue of talking to your GP about your weight as well as estimating body mass index online

We got very high interest from the public and everyone agreed it was a very worthwhile event
Year(s) Of Engagement Activity 2013
 
Description Engagement with Buckinghamshire GP teams 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact The aim was to launch the Buckinghamshire obesity strategy and show the evidence that this would work in primary care. I received very positive feedback on the talk
Year(s) Of Engagement Activity 2015
 
Description European Primary Care Cardiovascular Society 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact About 100 GPs from around Europe attended my lecture on practical approaches to intervening to promote health in the consultation. Afterwards I received many comments; one person said 'You have a great way of putting things so that it is easy to understand'.
Year(s) Of Engagement Activity 2015
 
Description FDF Nutrition Committee 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Industry/Business
Results and Impact Presentation to the Food and Drink Federation Nutrition Committee (approx 15 companies) to communicate findings from a systematic review on portion size and obesity and to discuss actions which business might take to mitigate the risk from large portions
Year(s) Of Engagement Activity 2015
 
Description GP out reach seminars 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach Regional
Primary Audience Health professionals
Results and Impact We have done 8 presentation about the trial to GP practices. The audience included a mixture of staff from practice managers to GPs to research nurses. This initiated discussions about the trial and lead to expressions of interest being given to run the trial within those practices.

We were able to get practices interested in taking part in our trial.
Year(s) Of Engagement Activity 2012,2013
 
Description GPs at East Oxford Health Centre used our materials for a local training day 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Our training materials for the trial are widely regarded by GPs as relevant and helpful and also novel for them. Some local GPs organise the local GP education sessions and asked to use our materials for one of the GP education sessions

The talk was well received and people reported that they were motivated to take action as a result of the training.
Year(s) Of Engagement Activity 2013
 
Description ITV Tonight: Childhood obesity programme 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Interview as part of 30 min prime-time programme
Year(s) Of Engagement Activity 2015
 
Description Institute of Child Health Seminar series 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Talk on weight management in primary care
Year(s) Of Engagement Activity 2014
 
Description Interview with Tom Kerridge 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Interviewing a celebrity chef about his weight loss experience and relating that to the scientific evidence about weight loss as part of Oxfordshire Science Festival. Tom Kerridge was a big draw and as a result we had a different audience than usual attendees at public events. The room was packed on one of the hottest days of the year and evaluation was overwhelmingly positive. We recruited 72 people to join our Public Panel.
Year(s) Of Engagement Activity 2017
 
Description Keynote address at UK Society for Behavioural Medicine 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact This was a keynote presentation to a key audience of colleagues who work in similar ways in which I described the mechanisms underlying the effect of the intervention on behaviour and what that tells us about treatment.
Year(s) Of Engagement Activity 2016
URL https://www.kc-jones.co.uk/uksbm2016
 
Description Lecture: Diet, obesity and health: from science to policy - Jenner Society 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Invited talk on our research and careers in science to Sixth Form science students
Year(s) Of Engagement Activity 2018
 
Description Lecture: How to help your patients lose weight - Society for Endocrinology 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Invited lecture for Society for Endocrinology Clinical Update
Influenced professional practice to encourage greater attention to weight management
Year(s) Of Engagement Activity 2018
 
Description Lecture: Nutrition - 2nd Year Medical Students - University of Oxford 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact Lecture to 2nd Year medical students at MSTD University of Oxford.
Fostered awareness of diet/health links and opportunities for intervention
Year(s) Of Engagement Activity 2018
 
Description Lecture: Obesity - Brasenose Medical Society 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Invited lecture.
Fostered awareness of diet/health links, opportunities for intervention and role of practitioners
Year(s) Of Engagement Activity 2018
 
Description Lecture: Treating obesity in routine healthcare settings - Malaysian ASO 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk to University of Putra Malaysia for Association for the Study of Obesity.
Student education. Raised profile of our research. Discussions on possible Newton funding collaborations.
Year(s) Of Engagement Activity 2018
 
Description Member of a NICE panel on weight loss management 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The panel produced national guidance on lifestyle weight management

It is too soon to evaluate the impact of the guidance
Year(s) Of Engagement Activity 2013
URL http://www.nice.org.uk/guidance/ph53
 
Description NHS England South Central Medical Directorate Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Talk to present data on clinical and cost effectiveness of interventions to treat obesity
Year(s) Of Engagement Activity 2017
URL http://tvscn.nhs.uk/wp-content/uploads/2017/01/Agenda-for-7-June-conference.pdf
 
Description NIHR CLAHRC Oxford stakeholder event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Talk to describe results of research in Diet and Obesity theme of Oxford CLAHRC
Year(s) Of Engagement Activity 2017
 
Description Newspaper Article: Fat-shaming is wrong but obesity is dangerous 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The Times article by Alice Thomson.
Stimulating debate on public health policies
Year(s) Of Engagement Activity 2018
URL https://www.thetimes.co.uk/edition/comment/fat-shaming-is-wrong-but-obesity-is-dangerous-82ck7dh2z
 
Description Newspaper Article: Formula Meal Plan can tackle obesity in the short term - The Guardian 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Article by Sarah Boseley, Health Editor - 'Formula meal plan can tackle obesity in the short term' - report on data from the DROPLET trial, presented at the World Obesity Conference in Vienna.
Study cited in DH press release as stimulus to NHS adoption of similar treatment.
Year(s) Of Engagement Activity 2018
URL https://www.theguardian.com/society/2018/may/25/formula-meal-diet-plan-can-tackle-obesity-in-short-t...
 
Description Newspaper Article: Sugar Tax - The Times 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Newspaper Article re introduction of Sugar Tax this week.
Stimulating debate on public health policies
Year(s) Of Engagement Activity 2018
 
Description Newspaper Article: The Big Crash Diet Experiment - The Telegraph 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Article by Michael Hogan re the Screening of the television show The Big Crash Diet Experiment.
NHS adoption of similar treatment.
Year(s) Of Engagement Activity 2018
URL https://www.telegraph.co.uk/tv/2018/05/30/big-crash-diet-experiment-review-useful-solution-tubby-tel...
 
Description Newspaper Article: Yes, crash diets can work (if you're overweight enough) - The Times 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Newspaper interview following publication of study.
NHS adoption of similar treatment announced in 2019 Long Term Plan.
Year(s) Of Engagement Activity 2018
 
Description Newspaper Interview: Doctors should make patients go on diets - The Times 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact 2 page profile piece by Rachel Sylvester and Alice Thomson.
Stimulating debate on public health policies
Year(s) Of Engagement Activity 2018
URL https://www.thetimes.co.uk/article/doctors-should-make-patients-go-on-diets-fp05xmsc6
 
Description North Oxford Rotary Club 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Lunchtime discussion about diet and health
Year(s) Of Engagement Activity 2016
 
Description Obesity, diet and lifestyle networking event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact BRC Obesity, Diet and Lifestyle Networking Event at Old Road Campus
Year(s) Of Engagement Activity 2018
 
Description Oxfordshire Science Festival 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Short presentation and extended Q&A about aetiology and management of obesity, based on BBC series
Year(s) Of Engagement Activity 2015
 
Description PCRN National Conference (2013) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact The team were asked to contribute to a master class in weight management studies. The presentation was delivered to 60 health professionals working within Primary Care.

We raised awareness of the trial to different PCRN areas and also new GP practices who engaged with the BWeL Trial.
Year(s) Of Engagement Activity 2013
 
Description Presentation to European Primary Care Cardiovascular Society 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The talk was well received and it was based upon our training for the BWeL trial. A practitoner said to me afterwards that 'you have the ability to understand the questions I want to ask and answer them'.

Colleagues reported that it changed their views about the value of intervention on obesity
Year(s) Of Engagement Activity 2013
 
Description Presentation to International Congress on Obesity 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Presented BWeL trial to an international audience
Year(s) Of Engagement Activity 2016
 
Description Presentation to Magill Symposium at Chelsea and Westminster Hospital 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The talk led to lots of questions and a panel discussion

The audience reported that their knowledge of obesity and its management improved
Year(s) Of Engagement Activity 2013
URL http://imperial-anaesthesia.org.uk/?page=20&postid=223
 
Description Presentation to UK Congress on Obesity 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This was a talk about the language used by GPs and how talk shapes action in patients. The audience included practising clinicians
Year(s) Of Engagement Activity 2016
 
Description Presentation: 'Policy initiatives to tackle obesity in England' - Australian Government Obesity Summit 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Skype Presentation 'Policy initiatives to tackle obesity in England' to Australian Government Obesity Summit
Year(s) Of Engagement Activity 2019
 
Description Presentation: Behaviour change to improve health - Academy of Medical Sciences 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation at Academy of Medical Sciences Rosenthal Symposium
Year(s) Of Engagement Activity 2019
 
Description Presentation: CTU study updates - GP Day - Eynsham Hall 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Presentation for GP Day at Eynsham Hall re CTU study updates
Year(s) Of Engagement Activity 2018
 
Description Presentation: Knowledge, nudge or nanny - how might we change what we eat? - Ellesmere College 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Presentation to School pupils and parents at Ellesmere College.
Raised awareness of importance of diet to long term health.
Raised interest in careers in nutrition science
Year(s) Of Engagement Activity 2018
 
Description Presentation: Obesity policy in England - NSW Treasury 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Talk to NSW Treasury on obesity policies in UK.
Informing NSW obesity strategy
Year(s) Of Engagement Activity 2018
 
Description Presentation: Screening and brief intervention trial - Dept of Population Health 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk at Collaborators meeting for Nuffield Dept of Population Health (investigators, potential investigators and senior trial managers)
Year(s) Of Engagement Activity 2018
 
Description Presentation: Talking the Talk - RCGP Annual Primary Care Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation to GPs re acceptable and effective brief interventions for weight control
Year(s) Of Engagement Activity 2018
 
Description Presentation: Treating obesity - Oxford Women's Health Annual Study Day 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Treating Obesity Presentation.
Evalutation reported that some audience members planned to change their practice and offere weight management interventions.
Year(s) Of Engagement Activity 2018
 
Description Presentation: What can doctors do to tackle obesity? - Somerville College 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Presentation 'What can doctors do to tackle obesity? at Somerville College, Oxford
Year(s) Of Engagement Activity 2019
 
Description Presentation: What's new in primary care trials - Society for Endocrinology - Obesity Update Conference 2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Society for Endocrinology Obesity Update 2018 Conference
Year(s) Of Engagement Activity 2018
 
Description Public Talk: NIHR BRC Oxford Public Lecture - Obesity Week - Is dieting worth it? - JR Hospital 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Public Talk for Obesity Week at JR Hospital.
Stimulated public awareness of effective ways to lose weight.
Year(s) Of Engagement Activity 2018
 
Description Public engagement 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact We realised the the BWeL trial was major news for the way that GPs engage with obesity in their patients and that this had implications practitioners, patients, and the general public. We also wanted to maximise the impact of the publication and we prepared a strategy for doing so. Working jointly with the Lancet, we lined up several doctors, patients from the trial, and me to be free to talk to the media. We briefed friends in the media beforehand and we sent the paper to several key opinion leaders, both in public heath research and in clinical practice. The efforts were a big success. The altmetric score is currently 1435 and rising because whenever the topic of GPs talking to patients who are overweight is raised it is often quoted. There was blanket coverage on national TV, radio, and print-based news. In addition, we have done an analysis of the coverage and used this to learn lessons about press releases in the future. We aim to maximise coverage, but reduce stigma associated with obesity and many news outlets used stigmatising images. We will therefore issue suggested images to go alongside a press release in future. In addition, the analysis of comments on online responses to news articles suggested some people changed their views on the topic.
Year(s) Of Engagement Activity 2016
 
Description Radio Interview: Fat in Diets - BBC Five Live Afternoon Edition 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Radio Interview with Katie Tunstall.
dispelling myths about food
Year(s) Of Engagement Activity 2018
 
Description Radio Interview: Government initiatives to tackle obesity - BBC Radio 4 World at One 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Interview with Mark Mardell re Government initiatives to tackle obesity.
Contributing to public debate on food policies
Year(s) Of Engagement Activity 2018
 
Description Radio Interview: Obesity Week - BBC Radio Oxford 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Radio Interview for Obesity Week.
Contributing to public discussion on obesity.
Year(s) Of Engagement Activity 2018
 
Description Radio Interview: Weight - Audible 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Radio interview as part of 6 part documentary series on Weight hosted by Dr Giles Yeo, Cambridge geneticist
Year(s) Of Engagement Activity 2018
 
Description Radio Interview: Weight-loss drugs to treat obesity - BBC Radio 4 World at One 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Interview re Weight-loss drugs to treat obesity.
Putting drug treatment for obesity in context of what can be achieved through dietary interventions
Year(s) Of Engagement Activity 2018
 
Description Richard Doll Seminar Series 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact Talk on "New evidence from trials to inform the management of obesity in routine care"
Audience of about 150

In following week, two doctors spontaneously reported that they had changed their practice and made a brief intervention for weight management with a patient
Year(s) Of Engagement Activity 2016
 
Description Seminar for BBSRC Head Office 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact Seminar for staff at BBSRC head Office and discussions related to funding for diet and health research
Year(s) Of Engagement Activity 2017
 
Description South West Public Health Conference, Weight loss support as public health intervention 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact This was a CPD update for public health practitioners in South West England
Year(s) Of Engagement Activity 2017
 
Description TVSCRN Obesity Webinar 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Webinar on effective intervention to treat obesity in primary care
Year(s) Of Engagement Activity 2017
URL http://tvscn.nhs.uk/wp-content/uploads/2017/05/TVSCRN-webinar-Brief-Interventions-for-Weight-Managem...
 
Description Talk to GPs at World Congress on National Academies of Family Doctors (WONCA) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was a talk in which I presented how to change behaviour in a consultation using the BWeL example.
Year(s) Of Engagement Activity 2016
 
Description Talk to GPs for Cancer Research UK 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact This was a talk to discuss prevention and how it can be incorporated easily into the consultation.
Year(s) Of Engagement Activity 2016
 
Description Talk to Glasgow University 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact In this talk I presented our research on weight management and what it has achieved.
Year(s) Of Engagement Activity 2017
 
Description Talk to International Congress of Behavioural Medicine 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was a presentation of the BWeL trial at a major international congress.
Year(s) Of Engagement Activity 2016
 
Description Talk to Thames Valley GPs 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact I talked to regional GPs about the BWeL and how to use the findings in everyday practice. Several GPs reported that they would do so.
Year(s) Of Engagement Activity 2016
 
Description Talk to UKCRC centres of excellence in public health conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation of BWeL trial results
Year(s) Of Engagement Activity 2016
 
Description Teaching at Warwick University on the MSc programme 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact The talk sparked lots of questions

The students found the session very informative and gave it high ratings
Year(s) Of Engagement Activity 2013
 
Description Television Interview: NHS at 70 - BBC 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Article to celebrate the NHS at 70 - filming at JR Hospital.
Encouraged public support for work of NHS
Year(s) Of Engagement Activity 2018
 
Description Television Interview: Obesity and Ill health - Sky News 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact News article.
Contributing to public awareness of effectiveness of obesity treatment
Year(s) Of Engagement Activity 2018
 
Description Television Interview: Total Diet Replacement Programmes - BBC Breakfast TV 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Interview following announcement from NHS about offering TDR (DROPLET study).
Raising public awareness of effectivess of weight loss to prevent/treat diabetes.
Year(s) Of Engagement Activity 2018
 
Description Television Screening: Britain's Fat Fight - BBC1 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Screening of the television show exploring the obesity crisis with celebrity Chef Hugh Fearnley-Whittingstall. The programme featured a rerun of our BWeL trial concerning brief interventions and showed how acceptable and effective these were.
Year(s) Of Engagement Activity 2018
URL https://www.phc.ox.ac.uk/news/hugh-fearnley-whittingstall-puts-oxford-university2019s-weight-loss-re...
 
Description Television Screening: The big Crash Diet Experiment 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact 1 hour science programme with four overweight volunteers putting crash dieting to the test. Input into development of programme and on screen expert.
Stimuls to announcement by NHS to pilot this type of intervention to treat diabetes.
Year(s) Of Engagement Activity 2018
 
Description Thames Valley Strategic Clinical Network Conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact A regional event to promote service innovation by learning from research. Presented new findings primarily from NPRI funded studies on weight management in adults. Evaluation forms found it to be the most highly rated presentation on the day with some reporting intention to change practice. Asked by regional Medical Director to do a video interview, subsequent webinar for local commissioners and speak at follow up event..
Year(s) Of Engagement Activity 2016
 
Description The Osler Lecture - Oxford medical Alumni 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact A presentation to an alumni group of about 200 people, including many current medical practitioners. I received 4 or 5 emails subsequently requesting additional information and notes reporting a new awareness about the success of weight-loss interventions offered by health professionals with some correspondents specifically noting this would info;hence their practice.
Year(s) Of Engagement Activity 2016
 
Description Working with Cancer Research UK to develop a training programme for practitioners on brief interventions. 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This is an RCGP and CRUK group that is developing a training programme for practitioners to develop skills in delivering brief interventions and help to motivate them to do this. The obesity brief intervention is based on BWeL.
Year(s) Of Engagement Activity 2016,2017
 
Description Working with Public Health England to develop training for practitioners in weight management 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Public Health England are developing resources to help practitioners raise the issue of overweight and obesity with patients and train them in what to do. The brief intervention component is based on BWeL and the use of referral to weight management services is based on the WRAP trial. We are having regular phone conferences and editing the materials.
Year(s) Of Engagement Activity 2016,2017