Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK.
NIHR Oxford Biomedical Research Centre, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK.
Clin Obes. 2021 Dec;11(6):e12482. doi: 10.1111/cob.12482. Epub 2021 Oct 6.
Guidelines ask health professionals to offer brief advice to encourage weight loss for people living with obesity. We tested whether referral to one of three online programmes could lead to successful weight loss. A total of 528 participants aged ≥18 years with a body mass index of ≥30 kg/m were invited via a letter from their GP. Participants were randomised to one of three online weight loss programmes (NHS Weight Loss Plan, Rosemary Online or Slimming World Online) or to a control group receiving no intervention. Participants self-reported weight at baseline and 8 weeks. The primary outcome was weight change in each of the active intervention groups compared with control. We also compared the proportion of participants losing ≥5% or ≥10% of body weight. For Rosemary, Online mean weight loss was modestly greater than control (-1.5 kg [95% confidence interval (CI) -2.3 to -0.6]) and more than three times as many participants in this group lost ≥5% (relative risk [RR] = 3.64, 95% CI: 1.63-8.1). For Slimming World, mean weight loss was not significantly different from control (-0.8 kg [95%CI -1.7 to 0.1]), twice as many participants lost ≥5% (RR = 2.70, 1.17-6.23). There was no significant difference in weight loss for participants using the NHS Weight Loss Plan (-0.4 kg, [95% CI -1.3 to 0.5]), or the proportion losing ≥5% (RR = 2.09, 0.87-5.01). Only one of three online weight loss programmes was superior to no intervention and the effect size modest among participants living with obesity.
指南要求卫生专业人员提供简短建议，以鼓励肥胖患者减肥。我们测试了将患者转介至三种在线项目之一是否能成功减肥。共有 528 名年龄≥18 岁、BMI≥30kg/m2的患者通过全科医生的一封信被邀请参加。参与者被随机分配到三种在线减肥项目（NHS 减肥计划、Rosemary Online 或 Slimming World Online）或对照组（不接受干预）。参与者在基线和 8 周时自行报告体重。主要结果是每个积极干预组与对照组相比体重变化。我们还比较了体重减轻≥5%或≥10%的参与者比例。对于 Rosemary Online，平均体重减轻量明显大于对照组（-1.5kg[95%置信区间（CI）-2.3 至-0.6]），且该组中有更多的参与者体重减轻≥5%（相对风险[RR]为 3.64，95%CI：1.63-8.1）。对于 Slimming World，平均体重减轻与对照组无显著差异（-0.8kg[95%CI-1.7 至 0.1]），但有两倍多的参与者体重减轻≥5%（RR 为 2.70，1.17-6.23）。使用 NHS 减肥计划的参与者体重减轻量无显著差异（-0.4kg[95%CI-1.3 至 0.5]），或体重减轻≥5%的比例（RR 为 2.09，0.87-5.01）。三种在线减肥项目中只有一种优于无干预，且肥胖患者的效果适中。
