The implementation of the Counterweight Programme in Scotland, UK

Background. The Counterweight Programme is a proven model for the management of obesity in the UK, evaluated over 5 years (2000-05) and demonstrating clinical and cost effectiveness. The Scottish Government commissioned three phases of Counterweight implementation during the period 2006-08. The first two phases linked the Counterweight Programme to a primary care cardiovascular disease prevention programme; the third phase was commissioned independent of other interventions. Aim. To assess the implementation of the Counterweight Programme in 13 Health Boards in Scotland and compare 12-month outcomes with published Counterweight data. Methods. Patients with a body mass index (BMI) ≥ 30 kg/m2 or BMI ≥ 28 kg/m2 with at least one co-morbidity were screened for the Counterweight Programme. Patients were asked to attend nine structured appointments with a trained Counterweight Programme practitioner over 12 months. Results. Six thousand seven hundred and fifteen patients from 184 general practices, 16 pharmacies and one centralized community-based service in 13 Health Boards, with a mean BMI of 37 kg/m2 were enrolled in the Counterweight Programme. Twenty-six per cent had a BMI ≥ 40 kg/m2. Attendance for patients at 3, 6 and 12 months follow-up was 55%, 37% and 28%. Of those who attended at 12 months, 35.2% had maintained a weight loss of ≥5% compared to 30.7% in the original evaluation. Conclusions. Evaluation of the Counterweight Programme in Scotland demonstrated consistency in characteristics of patients enrolled into the programme. There was evidence of higher loss to follow-up in a population not routinely engaging with primary care but evidence of greater weight losses among those who attended.