5 Recommendations for research

5 Recommendations for research

The Programme Development Group (PDG) recommends that the following research questions should be addressed. It notes that 'effectiveness' in this context relates not only to the size of the effect, but also to cost effectiveness and duration of effect. It also takes into account any harmful or negative side effects.

All the research should aim to identify differences in effectiveness among groups, based on characteristics such as socioeconomic status, age, gender and ethnicity.

Findings should be published in peer reviewed journals.

5.1 How effective are lifestyle weight management programmes available in the UK, when directly compared using high-quality trials? In particular, what effect do specific components of a multicomponent lifestyle weight management programme have on adherence, effectiveness and cost effectiveness? This includes:

  • components, or combinations of components, that support weight loss or the prevention of weight regain

  • the effect of programme length, intensity, setting and means of delivery (examples of the latter include group, individual and remote support)

  • specific behaviour change techniques (using a recognised taxonomy)

  • the effect of new technologies

  • the effect of additional support services, such as self-help groups and networks

  • approaches to commissioning

  • processes for collecting long-term follow-up data.

5.2 How effective and cost effective are lifestyle weight management programmes available in the UK over at least at least 3 to 5 years, and ideally beyond 10 years. Specifically:

  • Do short-term (12-week) interventions provide adults with the self-management skills they need to maintain weight loss in the long term?

  • Are alternative approaches to weight management (such as approaches that focus on a healthy lifestyle, behaviour change and the prevention of weight gain rather than weight loss) effective and cost effective in the long term?

  • How effective and cost effective are programmes for people of different ages, gender, sexuality or from different ethnic or socioeconomic groups?

  • How effective and cost effective are programmes for specific population groups, such as adults with depression or with disabilities?

5.3 What is the effect of lifestyle weight management programmes available in the UK on:

  • Changes to dietary habits and choices, physical activity level and sedentary behaviour?

  • Wider lifestyle factors, such as sleeping patterns or stress management?

  • Psychological issues, such as body confidence or attitude, depression, anxiety or self-esteem?

  • Health conditions, such as changes to blood pressure or lipids?

  • Unintended outcomes such as musculoskeletal injuries, symptoms of an eating disorder; increased anxiety or depression?

  • User adherence and satisfaction?

  • Quality of life?

5.4 How can referrals to other services after involvement in a lifestyle weight management service be as effective and cost effective as possible? This includes: re-referrals to a lifestyle weight management service, referrals to other tiers of weight management services or referrals to other specialist services (such as alcohol or substance misuse). In particular:

  • How long should people wait before being re-referred to a programme?

  • Does re-referral to the same (or a similar programme) influence adherence, effectiveness or cost effectiveness?

  • In what circumstances should participants not be re-referred to the same (or a similar programme)?

  • Who is best placed to provide ongoing support after the programme, and does this differ according to whether someone completed the programme or met their weight loss goal?

  • Are there any unintended or adverse effects from repeated attempts to lose weight?

5.5 What effect does lifestyle weight management training for health professionals and lifestyle weight management staff have on:

  • The referral process, including patient satisfaction?

  • Programme outcomes (weight loss and prevention of weight regain), adherence to the programme and participants' satisfaction with it?

  • Staff confidence in discussing weight issues and any concerns about their own weight?

  • Staff ability to deliver the programme?

  • General approach of staff (that is, whether they adopt a 'respectful and non-judgemental' approach as a result)?

More detail identified during development of this guideline is provided in Gaps in the evidence.

  • National Institute for Health and Care Excellence (NICE)