Empowering primary care to tackle the obesity epidemic: the Counterweight Programme

Eur J Clin Nutr. 2005 Aug:59 Suppl 1:S93-100; discussion S101. doi: 10.1038/sj.ejcn.1602180.


Objective: To improve the management of obese adults (18-75 y) in primary care.

Design: Cohort study.

Settings: UK primary care.

Subjects: Obese patients (body mass index > or =30 kg/m(2)) or BMI> or =28 kg/m(2) with obesity-related comorbidities in 80 general practices.

Intervention: The model consists of four phases: (1) audit and project development, (2) practice training and support, (3) nurse-led patient intervention, and (4) evaluation. The intervention programme used evidence-based pathways, which included strategies to empower clinicians and patients. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation.

Main outcome measures: Proportion of practices trained and recruiting patients, and weight change at 12 months.

Results: By March 2004, 58 of the 62 (93.5%) intervention practices had been trained, 47 (75.8%) practices were active in implementing the model and 1549 patients had been recruited. At 12 months, 33% of patients achieved a clinically meaningful weight loss of 5% or more. A total of 49% of patients were classed as 'completers' in that they attended the requisite number of appointments in 3, 6 and 12 months. 'Completers' achieved more successful weight loss with 40% achieving a weight loss of 5% or more at 12 months.

Conclusion: The Counterweight programme provides a promising model to improve the management of obesity in primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Clinical Competence
  • Cohort Studies
  • Evidence-Based Medicine
  • Exercise / physiology
  • Female
  • Health Promotion / methods
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Nutritional Sciences / education*
  • Obesity / diet therapy
  • Obesity / drug therapy
  • Obesity / therapy*
  • Outcome and Process Assessment, Health Care*
  • Patient Compliance
  • Patient Education as Topic*
  • Physicians, Family
  • Primary Health Care / methods*
  • Primary Health Care / standards
  • Self Efficacy
  • Treatment Outcome
  • United Kingdom