Weight management support in primary care - who does it work for, and who doesn’t it work for? A retrospective CPRD population study examining health inequalities

Over a billion adults globally, including a quarter of UK adults, live with obesity. Obesity increases risks of physical and mental health issues. This includes heart disease, type 2 diabetes, certain cancers, depression, anxiety, and reduced quality of life.
Health problems caused by obesity cost the NHS over £6 billion each year.

The NHS provides a range of weight management support, most accessed through primary care via a GP. This support varies in intensity and may include brief lifestyle advice, referrals to dietitians or weight clinics, specialist lifestyle programs, weight loss
medicines, and referrals for surgery. Currently, the support a person gets depends on what’s available nearby and the local rules about who access them. Other research shows that not everyone is able to get access to the same kinds of weight
management support across the UK. Patients say they are not happy with this ‘postcode lottery’.

To provide the kind of tailored support patients say they want, we need to know what works best for whom. But, we don’t know who will get the most – and least - benefit from different types of weight management support. Patients say that understanding how well weight management support works for different people is one of the most important things we need to research.

This project will work out who benefits the most and least from different types of weight management support. We will do this using anonymised health records. We will look at records of patients whose medical notes show they got weight management support. We will look at what type of support they got (e.g., lifestyle programs, medication, surgery). We will then look at changes in their recorded weight over time and other health issues that patients tell us are important. We will look at how things like age, ethnicity, and other health conditions impact on this weight change over time and related health issues.

By finding which types of weight management support work best for specific groups, we can help GPs to offer better support. Also, there may be some groups in whom no current weight management support works very well. This will show us areas where we may need to develop new approaches to support them.