Weight change and initial nonattendance rates in a multidisciplinary clinic
Authors: James M. , Cleator J. , Hoyte R , Wilding J. P. 
Published: July 2008

Background:  The clinic was established in 1998 in response to the need for a local service for patients with obesity. It offers a multidisciplinary approach to managing obesity in a secondary care setting. Key members of the team include doctors, dietitians, physiotherapists and nurses. Referral criteria were a body mass index (BMI) >40 or BMI > 35 with two or more comorbidities. Referrals were accepted from primary or secondary care. The aims of the clinic are to halt further weight gain and promote 5–10% weight loss and then weight maintenance over 2 years. There are few published studies looking at the outcomes of hospital‐based obesity clinics. Patients referred to such clinics are likely to have made several attempts at weight loss and be considerably heavier than patients presenting in primary care for weight management. The aims of this study were to assess weight change and initial nonattendance rates in patients referred to a multidisciplinary weight management clinic.

Methods:  Data were collected from 103 consecutive patients referred to the weight management clinic over 7 months starting in March 2005. The data were collected retrospectively from clinical letters. Data collected included initial weight and BMI, weight at 6 and 12 months and the latest weight available if after 12 months. Absolute weight change and percentage change were calculated as well as the number of patients achieving clinically significant weight losses at each of the time points.

Results:  Initial nonattendance rates to the clinic was 15%. Table 1 shows the weight change at each of the time‐points audited:

 Weight change in the Aintree Weight Management Clinic [mean (SD)]

Time after attendance
Mean weight change Kg (SD)
Mean % weight change % (SD)
≥ 10% initial weight loss n (%)
≥ 5% initial weight loss n (%)
Some weight loss n (%)
No weight loss or weight gain n (%)

6 months (n = 58)
–3.1 (5.8)
–2.6 (4.4)
4 (7)
16 (28)
43 (74)
ss15 (26)

12 months (n = 47)
–5.2 (8.1)
–4.3 (6.5)
8 (17)
16 (34)
34 (72)
13 (28)

>12 months (n = 34)
–8.9 (14.7)
–6.9 (10.4)
9 (27)
16 (49)
24 (71)
10 (29)

Discussion:  The multidisciplinary clinic resulted in approximately a third of patients continuing to attend the clinic losing a clinically significant amount of weight of 5% or more (Goldstein, 1992). At any time‐point most patients continuing to attend lost weight which is encouraging as there is evidence that even lesser degrees of weight loss can be advantageous to health (Stevens et al., 2001). Only 15% of those referred did not attend the initial appointment and approximately 53% of those patients who attended the initial appointment were continuing to attend at 1 year and 39% at approximately 18 months to 2 years.

Conclusions:  A multidisciplinary clinic is effective in facilitating significant weight loss in patients with morbid obesity.

References  Goldstein, D.J. (1992) Beneficial health effects of modest weight loss. Int. J. obes. Relat. Meta. Disord. 16, 397–415.

Stevens, V.J., Obarzanek, E., Cook, N.R., Lee, I.‐M., Appel, L.J., Smithwest, D., Milas, N.C., MaHfeldt‐Beman, M., Belden, L., Bragg, C., Millstone, M., Raczynski, J., Brewer, A., Singh, B. & Cohen, J. (2001) Long term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Ann. Intern. Med.134: 1–11.