Counterweight as an Evidence based Practice:

Counterweight and its weight management programmes have been reviewed and refined over the last 12 years using a system of continuous improvement methodology. This ensures that the range of weight management programmes maintain their quality and continue to be based on the most up to date evidence available to the scientific community. Counterweight continues to maintain links with 6 key academic institutions enabling us to offer effective and evidence based weight management solutions to both NHS and corporate organisations.

‘The Counterweight Programme is a fully evaluated, cost-effective, evidence based weight management programme showing sustained weight loss at 2 years.’
 

Counterweight uses a theoretical Evidence Based Quality Assessment model of continuous improvement to meet its aim of improving the management of overweight and obesity in adults (18–75 years) in various settings by achieving medically valuable weight loss 5-10% (5-10kg) and sustaining this weight loss at 2 years. 

Prior to developing Counterweight there was no documented audit of a weight management programme in primary care in the UK. The programme was founded on evidence based elements (e.g. for diet composition, exercise, methods and duration of delivery) but there was no existing model of accepted practice or best practice.

For that reason, there could be no “control” arm for a comparative study. Instead, the Counterweight Programme used evidence founded methods, based on the 1996 SIGN guidelines and generated the first evidence base for a comprehensive weight management service in primary care.

Future research will now be able to use the current Counterweight Programme as a fully evidence based model of good practice, from which to evaluate new, improved, components and Bariatric Medicine Ireland seeks to be at the heart of this research.

Key elements in the current evidence base are which allows room for research for Bariatric Medicine Ireland are:

• Minimal interventions are ineffective e.g. email, flagging patient’s records and casual advice, are ineffective in generating weight loss or maintenance.
• Effective interventions have not yet been developed for children.
• Modest weight loss (5-10 kg) achieved by any intervention is effective in improving all CVD risk factors, except hypertension which often recurs despite weight loss maintenance
• The  Counterweight Programme is effective in providing >5% loss at 12-24 months for about 16% (1 in 6) of patients who enter the programme
• Of those who attend 6 of 9  appointments or more, about 50% are successful in losing and maintaining weight loss >5%
• The current Counterweight Programme is highly cost-effective. Reduced prescribing costs for successful patients are projected to out-weigh the total cost of providing the Counterweight Programme 
•  Conventional weight management in primary care is not effective for treatment of severe and complicated obesity when loss of >15 kg is required.

Publications regarding counterweight:

·         community pharmacy weight management programme: an evaluation of effectiveness
BMC Public Health April 2013

·         Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity
British Journal of General Practice 2013 Feb/Jan 2013

·         Effective UK weight management services for adults
Clinical Obesity - Jan 2012

·         A patient-centred approach to estimate total annual healthcare cost by body mass index in the UK Counterweight programme
International Journal of Obesity (2012)

·         The implementation of the Counterweight Programme in Scotland, UK
Family Practice 2012; 29:i139–i144 March 2012

·         Long-Term Cost Effectiveness of Weight Management in Primary Care.
International Journal of Clinical Practice (2010); 64(6), 775-783 Apr 2010