Nice calls for national database for weight-loss programmes

Lifestyle weight management programmes focus on reducing calories consumed and increasing physical activity. Photograph: Dominic Lipinski/PA

A national database for lifestyle weight management programmes that have achieved positive long-term results should be set up to help combat the obesity epidemic, government advisers have said.

The National Institute for Health and Clinical Excellence (Nice) said participants in such programmes – which focus on reducing calories consumed and increasing physical activity – lose 3% of their body weight on average, which if sustained would be enough to lower the risk of type 2 diabetes and high blood pressure.

Carol Weir, guidance developer for Nice and head of service for nutrition and dietetics at Leeds Community Healthcare NHS Trust, said: “Obviously, if you need to lose weight, the more weight you lose the better, and the health benefits derive from that, but even a 3% loss, kept up long-term, is beneficial and that is why we are recommending sensible changes that can be sustained lifelong.”

The NHS recommends that obese people should aim to lose between 5% and 10% of their weight, and Nice emphasised that it was not replacing that guidance. But it said people needed encouragement and achievable goals.

It found that Rosemary Conley, Slimming World and Weight Watchers had been shown to be effective at 12 to 18 months, and said lifestyle weight management programmes were “one part of the solution”, but robust data was not available for many of them.

Gill Fine, chair of the Nice guidance group, said: “The issue is the variation in the types of programme available, and this is a real challenge for local authorities who have limited resources available when commissioning programmes. If there was a central resource that local providers could go in and see those programmes which are effective, it would help them to commission.”

The group has also published guidelines on best practice for programmes, including ensuring the tone and content of all communications.

Dr Alison Tedstone, chief nutritionist at Public Health England, said: “Elements of PHE’s work to support effective commissioning are already contributing to delivering some of the recommendations that Nice has developed. PHE is currently developing its future obesity work plan, which includes supporting local public health teams to deliver lifestyle and weight management services that meet local needs.”

Richard Welbourn, president of the British Obesity and Metabolic Surgery Society, welcomed the Nice guidance but stressed the benefits of surgical interventions. “The fact remains that significant weight loss is hard to achieve and even harder to sustain, even with the help of health professionals,” he said. “We promote the safe and effective use of surgical strategies as part of a coordinated pathway of care for people who are obese. There is compelling evidence that weight-loss surgery is clinically effective, safe and cost-effective.”

Nice is reviewing its guidance on bariatric surgery, which it currently recommends for adults with a body mass index of more than 40 who have tried but failed to lose weight using non-surgical techniques. The revised guidance is due to be published in November.

Nice calls for national database for weight-loss programmes