Current weight management services
In the UK, resources for prevention and treatment of overweight and obesity are categorised into four “tiers”. Tier 1 represents non-medical community based resources; Tier 2 are primary care based resources and treatment programme; Tier 3 services are specialist multidisciplinary services designed for assessment and treatment of patients with severe obesity that has not responded to earlier interventions; Tier 4 services are bariatric surgical units.
Although NICE has advocated the principles of multidisciplinary, personalised behavioural intervention for Tier 3 clinics, the optimum design and delivery of such interventions is poorly researched.
Group-based behavioural intervention in Tier 3 services?
Tier 3 services face several major challenges. On the one hand there are rising numbers of referrals and limited resources, and on the other hand the evidence base for Tier 3 intervention is lacking. Therefore, rational commissioning decisions are problematic, as commissioners and providers do not know how best to structure and deliver interventions. Moreover, rising demand makes one-to-one delivery of behavioural intervention increasingly unrealistic. While one alternative may be group based behavioural intervention, it is not understood how these different aims can be reconciled.
There is already fairly widespread use of group activities in Tier 3 services, but this is primarily for information giving and educational purposes. On the other hand, use of group-based behavioural intervention as the core intervention in the Tier 3 service is unusual. The optimum design, delivery and effectiveness of group-based behavioural intervention programmes in Tier 3 is poorly understood.
Delivery of Tier 3 Specialist Weight Management Services National Survey
In preparation for the exciting new national programme of research to support people who have severe obesity, researchers at the University of Plymouth and the University of Exeter are running a survey of specialist weight management services.
If you lead or work in specialist weight management (Tier 3) services, please take a look at our survey.