Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten Up randomised controlled trial.
Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten Up randomised controlled trial.
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DOI：
10.1136/bmj.d6500
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发表时间：
2011-11-03
期刊：
影响因子：
--
通讯作者：
Aveyard P
中科院分区：
文献类型：
--
作者：
Jolly K;Lewis A;Beach J;Denley J;Adab P;Deeks JJ;Daley A;Aveyard P
目的评价一系列体重管理方案在减肥方面的有效性。设计八组随机对照试验。在英国伯明翰建立初级保健信托。参与者740名肥胖或超重的男性和女性，从一般实践记录中确定患有合并症。干预措施：持续12周的减肥计划：Weight Watchers；减肥;迷迭香康利;以小组为基础，以营养为主导的方案；全科一对一辅导；药房进行一对一咨询；六项课程任选一项。向比较国小组提供了12张免费进入当地休闲（健身）中心的代金券。主要结局指标：主要结局指标为项目结束时（12周）体重减轻。次要结果是一年后体重减轻，自我报告的身体活动，以及计划结束和一年后体重减轻的百分比。结果在项目结束时，658名（88.9%）参与者和522名（70.5%）参与者可获得随访数据。从基线到项目结束，所有项目都取得了显著的体重减轻（范围从1.37公斤（全科实践）到4.43公斤（慧俪轻体）），除了全科实践和药房提供外，所有项目在一年内都取得了显著的体重减轻。一年后，只有慧俪轻体组的减重明显高于对照组（减重2.5公斤（95%可信区间0.8 - 4.2））。与初级保健方案相比，商业方案在方案结束时取得了更大的减肥效果（平均差2.3(1.3至3.4)kg）。初级保健方案的费用最高。分配到选择组的参与者的结果并不比随机分配到项目组的参与者好。结论商业提供的体重管理服务比由专门培训人员领导的以初级保健为基础的服务更有效，成本更低，但效果不佳。当前对照试验ISRCTN25072883。
Objective To assess the effectiveness of a range of weight management programmes in terms of weight loss. Design Eight arm randomised controlled trial. Setting Primary care trust in Birmingham, England. Participants 740 obese or overweight men and women with a comorbid disorder identified from general practice records. Interventions Weight loss programmes of 12 weeks’ duration: Weight Watchers; Slimming World; Rosemary Conley; group based, dietetics led programme; general practice one to one counselling; pharmacy led one to one counselling; choice of any of the six programmes. The comparator group was provided with 12 vouchers enabling free entrance to a local leisure (fitness) centre. Main outcome measures The primary outcome was weight loss at programme end (12 weeks). Secondary outcomes were weight loss at one year, self reported physical activity, and percentage weight loss at programme end and one year. Results Follow-up data were available for 658 (88.9%) participants at programme end and 522 (70.5%) at one year. All programmes achieved significant weight loss from baseline to programme end (range 1.37 kg (general practice) to 4.43 kg (Weight Watchers)), and all except general practice and pharmacy provision resulted in significant weight loss at one year. At one year, only the Weight Watchers group had significantly greater weight loss than did the comparator group (2.5 (95% confidence interval 0.8 to 4.2) kg greater loss,). The commercial programmes achieved significantly greater weight loss than did the primary care programmes at programme end (mean difference 2.3 (1.3 to 3.4) kg). The primary care programmes were the most costly to provide. Participants allocated to the choice arm did not have better outcomes than those randomly allocated to a programme. Conclusions Commercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff, which are ineffective. Trial registration Current Controlled Trials ISRCTN25072883.
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影响因子：
158.5
作者：
Knowler, WC;Barrett-Connor, E;Nathan, DM
通讯作者：
Nathan, DM
影响因子：
6.9
作者：
Rock, Cheryl L.;Pakiz, Bilge;Quintana, Elizabeth L.
通讯作者：
Quintana, Elizabeth L.
影响因子：
4.5
作者：
Jolly, Kate;Daley, Amanda;Aveyard, Paul
通讯作者：
Aveyard, Paul
影响因子：
3.2
作者：
Rzewnicki, R;Auweele, YV;De Bourdeaudhij, I
通讯作者：
De Bourdeaudhij, I
影响因子：
168.9
作者：
Bray, G. A.;Chatellier, A.;Duncan, C.;Greenway, F. L.;Levy, E.;Ryan, D. H.;Polonsky, K. S.;Tobian, J.;Ehrmann, D.;Matulik, M. J.;Clark, B.;Czech, K.;DeSandre, C.;Hilbrich, R.;McNabb, W.;Semenske, A. R.;Goldstein, B. J.;Smith, K. A.;Wildman, W.;Pepe, C.;Goldberg, R. B.;Calles, J.;Ojito, J.;Castillo-Florez, S.;Florez, H. J.;Giannella, A.;Lara, O.;Veciana, B.;Haffner, S. M.;Montez, M. G.;Lorenzo, C.;Martinez, A.;Hamman, R. F.;Testaverde, L.;Bouffard, A.;Dabelea, D.;Jenkins, T.;Lenz, D.;Perreault, L.;Price, D. W.;Steinke, S. C.;Horton, E. S.;Poirier, C. S.;Swift, K.;Caballero, E.;Jackson, S. D.;Lambert, L.;Lawton, K. E.;Ledbury, S.;Kahn, S. E.;Montgomery, B. K.;Fujimoto, W.;Knopp, R. H.;Lipkin, E. W.;Marr, M.;Murillo, A.;Trence, D.;Kitabchi, A. E.;Murphy, M. E.;Applegate, W. B.;Bryer-Ash, M.;Dagogo-Jack, S.;Frieson, S. L.;Lambeth, H.;Lichtermann, L. C.;Otkaei, H.;Rutledge, L. M. K.;Sherman, A. R.;Smith, C. M.;Soberman, J. E.;Williams-Cleaves, B.;Metzger, B. E.;Molitch, M. E.;Johnson, M. K.;Giles, M. M.;Larsen, D.;Niznik, C.;Pen, S. C.;Schinleber, P. A.;Nathan, D. M.;McKitrick, C.;Turgeon, H.;Abbott, K.;Altshuler, D.;Anderson, E.;Bissett, L.;Cagliero, E.;D'Anna, K.;Delahanty, L.;Florez, J. C.;Goldman, V.;Poulos, A.;Tseng, B.;Barrett-Connor, E.;Carrion-Petersen, M. L.;Horne, J.;Leos, D.;Mudaliar, S.;Smith, J.;Vejvoda, K.;Pi-Sunyer, F. X.;Lee, J. E.;Foo, S. T.;Hagamen, S.;Marrero, D. G.;Kelly, S. M.;Ackermann, R. T.;Fineberg, E. S.;Hadden, A.;Jackson, M. A.;Kirkman, M. S.;Mather, K. J.;Roach, P. J.;Wheeler, M. L.;Ratner, R. E.;Aroda, V.;Shapiro, S.;Bavido-Arrage, C.;Gibbs, P.;Uwaifo, Gl;Wiggins, R.;Saad, M. F.;Watson, K.;Botrous, M.;Jinagouda, S.;Budget, M.;Conzues, C.;Magpuri, P.;Ngo, K.;Xapthalamous, K.;White, N. H.;Das, S.;Santiago, A.;Brown, A. L.;Wernimont, C.;Saudek, C. D.;Whittington, T.;Clark, J. M.;Greene, A.;Jiggetts, D.;Mosley, H.;Reusing, J.;Rubin, R. R.;Stephen, S.;Utsey, E.;Schade, D. S.;Adams, K. S.;Hemphill, C.;Hyde, P.;Butler, L.;Canady, J. L.;Colleran, K.;Gonzales, Y.;Hernandez-McGinnis, D. A.;Katz, P.;King, C.;Crandall, J.;Brown-Friday, J. O.;Adorno, E.;Duffy, H.;Martinez, H.;Pompi, D.;Shamoon, H.;Walker, E. A.;Wylie-Rosett, J.;Orchard, T.;Jeffries, S.;Kramer, M. K.;Smith, M.;Kriska, A.;Pettigrew, J.;Semler, L.;Venditti, E.;Weinzierl, V.;Arakaki, R. F.;Baker-Ladao, N. K.;Isonaga, M. K.;Bermudez, N. E.;Mau, M. K.;Knowler, W. C.;Cooeyate, N.;Hoskin, M. A.;Natewa, C.;Percy, C. A.;Acton, K. J.;Andre, V. L.;Begay, S.;Bucca, B. C.;Cook, S.;Doughty, M. S.;Glass, J.;Glass, M.;Hanson, R. L.;Hassenpflug, D.;Ingraham, L. E.;Kobus, K. M.;Krakoff, J.;Manus, C.;McCabe, C.;Michaels, S.;Morgan, T.;Nelson, J. A.;Roy, R. J.;Smart, M.;Tonemah, D. P.;Wilson, C.;Fowler, S.;Brenneman, T.;Abebe, S.;Bamdad, J.;Callaghan, J.;Christophi, C. A.;Edelstein, S. L.;Gao, Y.;Gooding, R.;Gottlieb, A.;Grover, N.;Hoffman, H.;Jablonski, K.;Katz, R.;Kolinjivadi, P.;Lachin, J. M.;Ma, Y.;Reamer, S.;Sapozhnikova, A.;Sherif, H.;Temprosa, M.;Venditti, E. M.;Kriska, A. M.;Semler, L.;Weinzierl, V.;Marcovina, S.;Strylewicz, G.;Albers, J.;Prineas, R. J.;Alexander, T.;Campbell, C.;Hall, S.;Hensley, S.;Li, Y.;Mills, M.;Soliman, E.;Zhang, Z.;Fradkin, J.;Garfield, S.;Mayer-Davis, E.;Moran, R. R.;Ganiats, T.;Sarkin, A. J.
通讯作者：
Sarkin, A. J.