Skip to main content
Top
Published in: Current Obesity Reports 3/2019

Open Access 01-09-2019 | Obesity | Health Services and Programs (R Welbourn and CM Borg, Section Editors)

How Group-Based Interventions Can Improve Services for People with Severe Obesity

Authors: Dawn Swancutt, Mark Tarrant, Jonathan Pinkney

Published in: Current Obesity Reports | Issue 3/2019

Login to get access

Abstract

Purpose of Review

Rising demand for specialised “Tier 3” weight management services in England is exceeding capacity, leading many services to offer group-based care programmes. This review considers the organisation of current provision, exploring how group programmes may enhance services and how these could be scaled up for wider implementation.

Recent Findings

Existing group-based programmes mainly focus on providing patients with information and education about their condition. Evidence suggests that groups themselves offer therapeutic benefits beyond this, by underpinning patients’ engagement with programme materials and contributing to wider health and well-being. To maximise these benefits, there is a need to attend to the group processes that emerge in treatment groups which, left unchecked, may limit or even adversely impact programme outcomes.

Summary

Group-based interventions may be of benefit to patients in Tier 3 specialist weight management services, although their format is complex and reliant on facilitators’ expertise.
Literature
4.
go back to reference Welbourn R, Hopkins J, Dixon JB, Finer N, Hughes C, Viner R, Wass J, on behalf of the Guidance Development Group Commissioning guidance for weight assessment and management in adults and children with severe complex obesity. Obes Rev 2017. doi:https://doi.org/10.1111/obr.12601, 19, 14, 27. Welbourn R, Hopkins J, Dixon JB, Finer N, Hughes C, Viner R, Wass J, on behalf of the Guidance Development Group Commissioning guidance for weight assessment and management in adults and children with severe complex obesity. Obes Rev 2017. doi:https://​doi.​org/​10.​1111/​obr.​12601, 19, 14, 27.
5.
go back to reference U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2014 incidence and mortality web-based report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2017. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2014 incidence and mortality web-based report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2017.
8.
go back to reference National Institute for Health and Care Excellence. Obesity: identification, assessment and management. 2014. National Institute for Health and Care Excellence. Obesity: identification, assessment and management. 2014.
10.
go back to reference Public Health England. National mapping of weight management services 2015 Report No.: 2015521. Public Health England. National mapping of weight management services 2015 Report No.: 2015521.
12.
go back to reference Scottish Intercollegiate Guidelines Network (SIGN) Management of obesity: a national clinical guideline 2010. Contract No.: 115. Scottish Intercollegiate Guidelines Network (SIGN) Management of obesity: a national clinical guideline 2010. Contract No.: 115.
13.
go back to reference National Obesity Observatory. Standard evaluation framework for weight management interventions. 2009. National Obesity Observatory. Standard evaluation framework for weight management interventions. 2009.
15.
go back to reference • Dombrowski SU, O’Carroll RE, Williams B. Form of delivery as a key ‘active ingredient’ in behaviour change interventions. Br J Health Psychol. 2016;21(4):733–40. https://doi.org/10.1111/bjhp.12203 Form of delivery (all features through which behaviour change content is conveyed) is identified as influential in six important areas: operationalizing theories, enhancing behaviour change effectiveness, influencing engagement, determining users understanding, influencing effectiveness and for implementation/sustainability. CrossRefPubMed • Dombrowski SU, O’Carroll RE, Williams B. Form of delivery as a key ‘active ingredient’ in behaviour change interventions. Br J Health Psychol. 2016;21(4):733–40. https://​doi.​org/​10.​1111/​bjhp.​12203 Form of delivery (all features through which behaviour change content is conveyed) is identified as influential in six important areas: operationalizing theories, enhancing behaviour change effectiveness, influencing engagement, determining users understanding, influencing effectiveness and for implementation/sustainability. CrossRefPubMed
16.
go back to reference Booth A, Cantrell A, Preston L, Chambers D, Goyder E. What is the evidence for the effectiveness, appropriateness and feasibility of group clinics for patients with chronic conditions? A systematic review. Health Serv Deliv Res. 2015;3:1–194. https://doi.org/10.3310/hsdr03460.CrossRef Booth A, Cantrell A, Preston L, Chambers D, Goyder E. What is the evidence for the effectiveness, appropriateness and feasibility of group clinics for patients with chronic conditions? A systematic review. Health Serv Deliv Res. 2015;3:1–194. https://​doi.​org/​10.​3310/​hsdr03460.CrossRef
20.
go back to reference • Borek AJ, Abraham C, Greaves CJ, Tarrant M. Group-based diet and physical activity weight-loss interventions: a systematic review and meta-analysis of randomised controlled trials. Appl Psychol Health Well being. 2018. https://doi.org/10.1111/aphw.12121 In a sample of 47 RCT reporting 60 evaluations, group-based interventions were effective in promoting weight loss of 3.5 kg at 6 months, 3.4 kg at 12 months and 2.6 kg at 24 months. Explicitly targeting weight loss, men-only groups providing feedback and dietary goals were significantly associated with greater effectiveness ( p < 0.05). • Borek AJ, Abraham C, Greaves CJ, Tarrant M. Group-based diet and physical activity weight-loss interventions: a systematic review and meta-analysis of randomised controlled trials. Appl Psychol Health Well being. 2018. https://​doi.​org/​10.​1111/​aphw.​12121 In a sample of 47 RCT reporting 60 evaluations, group-based interventions were effective in promoting weight loss of 3.5 kg at 6 months, 3.4 kg at 12 months and 2.6 kg at 24 months. Explicitly targeting weight loss, men-only groups providing feedback and dietary goals were significantly associated with greater effectiveness ( p < 0.05).
21.
go back to reference • Avenell A, Robertson C, Skea Z, Jacobsen E, Boyers D, Cooper D, et al. Bariatric surgery, lifestyle interventions and orlistat for severe obesity: the REBALANCE mixed-methods systematic review and economic evaluation. Health Technol Assess. 2018;22(68):1–246. https://doi.org/10.3310/hta22680 Group support was identified as a feature that improves long-term weight loss. In the meta-analysis of group vs. individual care, authors found six relevant trials which overall showed a benefit from group programmes at 12 months in unadjusted and adjusted analyses, and results favoured group programmes at other time points. CrossRefPubMedCentralPubMed • Avenell A, Robertson C, Skea Z, Jacobsen E, Boyers D, Cooper D, et al. Bariatric surgery, lifestyle interventions and orlistat for severe obesity: the REBALANCE mixed-methods systematic review and economic evaluation. Health Technol Assess. 2018;22(68):1–246. https://​doi.​org/​10.​3310/​hta22680 Group support was identified as a feature that improves long-term weight loss. In the meta-analysis of group vs. individual care, authors found six relevant trials which overall showed a benefit from group programmes at 12 months in unadjusted and adjusted analyses, and results favoured group programmes at other time points. CrossRefPubMedCentralPubMed
25.
go back to reference Tarrant M, Hagger MS, Farrow CV. Promoting positive orientation towards health through social identity. In: Jetten J, Haslam SA, Haslam C, editors. The social cure: identity, health, and well-being. New York: Psychology Press; 2012. p. 39–54. Tarrant M, Hagger MS, Farrow CV. Promoting positive orientation towards health through social identity. In: Jetten J, Haslam SA, Haslam C, editors. The social cure: identity, health, and well-being. New York: Psychology Press; 2012. p. 39–54.
26.
go back to reference Haslam C, Jetten J, Cruwys T, Dingle G, Haslam A. The new psychology of health: unlocking the social cure: Routledge; 2018. Haslam C, Jetten J, Cruwys T, Dingle G, Haslam A. The new psychology of health: unlocking the social cure: Routledge; 2018.
27.
go back to reference • Tarrant M, Khan SS, Farrow CV, Shah P, Daly M, Kos K. Patient experiences of a bariatric group programme for managing obesity: a qualitative interview study. Br J Health Psychol. 2017;22(1):77–93. https://doi.org/10.1111/bjhp.12218 Through qualitative techniques, authors identified how participants attending a bariatric service used the group as a resource for lifestyle change; established psychological connections with others shared a social identity that acted as a mechanism to access educational materials and underpinned their experience of social support. CrossRefPubMed • Tarrant M, Khan SS, Farrow CV, Shah P, Daly M, Kos K. Patient experiences of a bariatric group programme for managing obesity: a qualitative interview study. Br J Health Psychol. 2017;22(1):77–93. https://​doi.​org/​10.​1111/​bjhp.​12218 Through qualitative techniques, authors identified how participants attending a bariatric service used the group as a resource for lifestyle change; established psychological connections with others shared a social identity that acted as a mechanism to access educational materials and underpinned their experience of social support. CrossRefPubMed
29.
go back to reference • Nackers LM, Dubyak PJ, Lu X, Anton SD, Dutton GR, Perri MG. Group dynamics are associated with weight loss in the behavioral treatment of obesity. Obesity (Silver Spring). 2015;23(8):1563–9. https://doi.org/10.1002/oby.21148 Using the Group Climate Questionnaire-Short Form (GCQ-S) with 105 participants, authors found that at the group level, conflict and weight change at month 6 were associated such that groups that experienced greater conflict demonstrated smaller weight losses (Spearman’s R = 0.79; 95% CI = (0.18, 0.96); P = 0.016). CrossRef • Nackers LM, Dubyak PJ, Lu X, Anton SD, Dutton GR, Perri MG. Group dynamics are associated with weight loss in the behavioral treatment of obesity. Obesity (Silver Spring). 2015;23(8):1563–9. https://​doi.​org/​10.​1002/​oby.​21148 Using the Group Climate Questionnaire-Short Form (GCQ-S) with 105 participants, authors found that at the group level, conflict and weight change at month 6 were associated such that groups that experienced greater conflict demonstrated smaller weight losses (Spearman’s R = 0.79; 95% CI = (0.18, 0.96); P = 0.016). CrossRef
33.
go back to reference Steffens N, Haslam SA, Reicher SD, Platow MJ, Fransen K, Yang J, et al. Leadership as social identity management: introducing the Identity Leadership Inventory (ILI) to assess and validate a four-dimensional model. Leadersh Q. 2014;25(5):1001–24.CrossRef Steffens N, Haslam SA, Reicher SD, Platow MJ, Fransen K, Yang J, et al. Leadership as social identity management: introducing the Identity Leadership Inventory (ILI) to assess and validate a four-dimensional model. Leadersh Q. 2014;25(5):1001–24.CrossRef
34.
go back to reference Pearson D, Grace C. Weight management: a practitioner’s guide. Wiley-Backwell: UK; 2012.CrossRef Pearson D, Grace C. Weight management: a practitioner’s guide. Wiley-Backwell: UK; 2012.CrossRef
35.
go back to reference Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: Medical Research Council. 2006. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: Medical Research Council. 2006.
Metadata
Title
How Group-Based Interventions Can Improve Services for People with Severe Obesity
Authors
Dawn Swancutt
Mark Tarrant
Jonathan Pinkney
Publication date
01-09-2019
Publisher
Springer US
Keywords
Obesity
Obesity
Published in
Current Obesity Reports / Issue 3/2019
Electronic ISSN: 2162-4968
DOI
https://doi.org/10.1007/s13679-019-00348-y

Other articles of this Issue 3/2019

Current Obesity Reports 3/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.