UKCO Abstracts
The abstract poster display will be available in the exhibition space in Conference Room 1 from 08:45 hours on Thursday until the end of the congress.
Displaying 26 - 50 of 115 abstractsJuliet Finnie 1, Thomas Curtis 1, Victoria Lawson 1, Lucy Diamond 1, Andy Ho 1, Neel Gupta 1
1) Oviva, London, UK
📌 Allocation: Poster (Board No. 32)
The impact of obesity is not experienced equally across UK society, with higher levels of obesity associated with higher levels of deprivation and a widening gap in obesity rates between highest and lowest deprivation groups. Uptake and completion of weight management services is unequal with reduced uptake of traditional face to face services in those in higher levels of deprivation. The NHS has committed to reducing health inequalities and providing weight management services that are accessible to all groups. The authors aimed to provide a specialist digital and remote tier 3 service that increases uptake and engagement for participants across all IMDD. A 12 month multidisciplinary tier 3 weight management service was provided, including specialist dietary coaching and psychology support. Participants were offered a choice of coaching via a digital app or a remote phone pathway. Total diet replacement (TDR) was offered as a treatment option at no cost to the participant. GLP-1 (Liraglutide) treatment was prescribed where clinically appropriate. 3387 referrals were received across all 10 indices of multiple deprivation deciles (IMDD), with similar uptake, retention at 3 months and weight loss across each decile. Although there were variations between each decile, there was no trend towards better outcomes at either end of in the IMDD scale: Uptake from referral at IMDD 1 to 10 respectively: 45%, 46%, 53%, 45%, 47%, 47%, 53%, 54%, 48%, 56% Retention at 3 months at IMDD 1 to 10 respectively: 60%, 54%, 67%, 59%, 57%, 52%, 49%, 61%, 64%, 52%. Weight loss at 6 months at IMDD 1 to 10 respectively: 7.6%, 6.0%, 9.1%, 8.6%, 9.9%, 7.3%, 8.5%, 7.4%, 7.7%, 7.1% In conclusion, a digital and remote specialist tier 3 weight management service can contribute to the NHS priority of promoting equality of service access. Contributing factors to equality of access and outcome may be fully funded TDR, out of hours appointments/messaging, psychology support, a digital app based on behaviour change theory, establishing links with referring GPs and local community signposting.
Conflicts of interest: None
Funding: None
Juliet Finnie 1, Thomas Curtis 1, Victoria Lawson 1, Lucy Diamond 1, Andy Ho 1, Neel Gupta 1
1) Oviva, London, UK
📌 Allocation: Poster (Board No. 33)
The impact of obesity is not experienced equally across UK society, with people from a South Asian background experiencing complications of obesity such as type 2 diabetes at a lower BMI. Compounding this, uptake of group weight management services has been reported to be lower in South Asian populations compared to White populations. The NHS has committed to reducing health inequalities and providing weight management services that are accessible to all groups.
The authors aimed to provide a specialist tier 3 weight management service that generates strong uptake and clinical outcomes regardless of ethnic and cultural background. A 12 month multidisciplinary tier 3 weight management service was provided, including specialist dietary coaching and psychology support where required. Participants were offered a choice of digital app coaching or remote phone coaching, and 1:1 or group coaching. A choice of total diet replacement or other evidence based dietary approaches were offered. GLP-1 (Liraglutide) treatment was prescribed where clinically appropriate. 66 Asian ethnicity participants and 2102 White ethnicity participants were referred. Although referral numbers were smaller, equivalent or superior uptake, retention and weight loss outcomes were found in Asian ethnicity participants in comparison to White ethnicity participants: Uptake from referral: 72% (Asian), 58% (White). Retention at 6 months: 52% (Asian), 49% (White). Weight loss at 6 months: 8.8% (Asian), 8.5% (White). Participants from non-white ethnic backgrounds have often been considered ‘harder to reach’ in the provision of weight management interventions. Contributing factors to this may be the use of a ‘one size fits all’ approach, for example lack of choice of dietary approaches or coaching pathway. The results here indicate that this intervention was equally acceptable and effective in Asian participants compared to White participants. Key factors in achieving these outcomes may be the provision of pathway choice (digital vs phone, group vs 1:1), culturally inclusive learning content, specialist dietary input to tailor interventions to cultural requirements, establishing links with referring GPs and community signposting. These positive outcomes should be used to support the generation of larger referral volumes in people from an Asian background living with obesity.
Conflicts of interest: None
Funding: None
Juliet Finnie 1, Thomas Curtis 1, Victoria Lawson 1, Lucy Diamond 1, Andy Ho 1, Neel Gupta 1
1) Oviva, London, UK
📌 Allocation: Poster (Board No. 34)
Tier 3 weight management services have the potential to reduce the impact of obesity on both the individual and society. However, uptake and completion of weight management services is unequal with reduced uptake of traditional face to face services in males, and working age participants. The NHS has committed to reducing health inequalities and providing weight management services that are accessible to all groups. The authors aimed to provide a specialist tier 3 weight management service that increases uptake and engagement for all participants. A 12 month multidisciplinary tier 3 weight management service was provided, including specialist dietary coaching and psychology support where required. Participants were offered a choice of digital app or remote phone coaching as well as group or one to one. Evening and weekend phone appointments and asynchronous messaging aimed to increase accessibility. Total diet replacement was offered. GLP-1 (Liraglutide) treatment was prescribed where appropriate. 2750 females and 852 males were referred. Male participants achieved similar uptake and retention outcomes, and superior weight loss outcomes when compared to female participants: Uptake from referral: 44% (Male), 49% (Female). Retention at 6 months: 46% (Male), 51% (Female). Weight loss at 6 months: 10.8% (Male), 7.7% (Female). 3252 referrals were received for participants under 66 years (‘working age’) and 381 referrals for age 66+. Working age participants demonstrated similar uptake, retention and weight loss compared to over 66 years participants: Uptake from referral: 55% (working age), 45% (66+ years). Retention at 6 months: 50% (working age), 56% (66+ years). Weight loss at 6 months: 8.1% (working age), 7.2% (66+ years). The results presented demonstrate good uptake and weight loss outcomes in males and working age participants who may be considered ‘harder to reach’ in traditional face to face tier 3 services. Contributing factors may be the provision of a choice of pathways (1:1, group, digital app, or remote phone), social support where groups are chosen, app technology based on behaviour change theory, appointments outside working hours, asynchronous messaging and the provision of psychology support when required.
Conflicts of interest: None
Funding: None
Alice R. Kininmonth 1*, Andrea Smith 2*, David Boniface 1, Christina Vogel 3, and Clare Llewelyn 1
1 Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
2 MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
3 Centre for Food Policy, City, University of London (UK)
*Denotes joined first authorship
📌 Allocation: Poster (Board No. 35)
Rates of food insecurity have dramatically increased in the UK in the past year; with 21.6% of households with children experiencing food insecurity in 2023, compared to 12% in 2022. Food insecurity is linked to poorer health outcomes, especially among children, with an increased risk of developing obesity in later life. This study aimed to understand how family food cultures, experiences and behaviours differ between families with varying levels of food security. A sample of socioeconomically diverse families from four London boroughs were recruited via primary schools (n=739). Primary caregivers completed a one-to-one computer assisted interview with a trained researcher, reporting on: their family food security status; the family home food environment; their feeding practices; and their child’s food preferences and eating behaviours. Complex samples generalised linear models examined associations between food security status and family food-related outcomes. Analyses were adjusted for clustering at the school-level and children’s age, sex, and ethnicity, and used an alpha level <0.01. Overall, 28.4% of families were classified as living with food insecurity. Families experiencing food insecurity had a more obesogenic home food environment compared to food secure families (β=0.10, SE±0.03,p<0.001). Parents experiencing food insecurity used more emotional feeding (β=0.10±0.04,p=0.009), instrumental feeding (β=0.14 ±0.05,p=0.002), pressuring feeding practices (β=0.12 ±0.03,p<0.001), and exerted less structure/control over timing and quality of meals and snacks (β=-0.11 ±0.04,p=0.010), compared to food secure families. Children experiencing food insecurity expressed: higher responsiveness to food cues (β=0.12 ±0.03,p<0.001); higher emotional over- and under-eating (β=0.15 ±0.04,p<0.001 and β=0.14 ±0.04,p<0.001, respectively); higher desire to drink (β=0.11 ±0.04,p<0.01); and had lower preference for snack foods compared to food secure families (β=-0.12 ±0.04,p=0.005). These findings highlight potential mechanisms through which food insecurity predisposes children to poorer health outcomes and greater obesity risk. Additionally, they provide timely insights into how the home food environment and feeding practices differ between families with varying levels of food security and indicate that interventions targeting childhood eating behaviour and obesity must consider the context in which families experiencing food insecurity live and ensure good quality food is available and affordable for all families, particularly during the current cost of living crisis.
Conflicts of interest: The authors have no conflict of interest.
Funding: This work was funded by the NIHR Public Health Research Programme [12977]
Sabrina P Demirdjian 1, Maeve Kerr 1, Maria Mulhern 1, Paul Thompson 1, Mary McCann 1
1 Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, UK
📌 Allocation: Poster (Board No. 36)
The nutritional status of women of reproductive age (WRA) can be negatively impacted by overweight/obesity (Ow/Ob), with the magnitude of the impact on iron status remaining unclear. We aim to examine the influence of adiposity on iron status in non-pregnant WRA.
Women aged 18-49 years were selected from NDNS years 9-11 (2016-2019). BMI, waist circumference (WC), waist/height, and waist/hip ratio were used as markers of adiposity; haemoglobin, red blood cell count (RBC), mean cell haemoglobin (MCH), mean cell volume and serum ferritin (SF) were used as markers of iron status. Iron Deficiency Anaemia (IDA) was defined as SF<15μg/L and haemoglobin <120g/L; and low iron stores without anaemia (LISWA) as SF<30μg/L and haemolgobin ≥120g/L. SF was adjusted for inflammation (C-reactive protein (CRP)) by internal regression correction. Analysis was adjusted for smoking and age.
241 women were included, 47% categorised as normal weight (Nw) and 52% with Ow/Ob. LISWA was detected in 40.2% (Nw 40.9%, Ow/Ob 39.7%;) of women, and IDA detected in 5.8% (Nw 3.5%, Ow/Ob 7.9%) with no statistical difference between BMI groups. Anthropometric measurements correlated positively with RBC (particularly BMI r=0.22, WC r=0.21 and hip r=0.21, all p<0.001), CRP (particularly BMI r=0.51, WC r=0.51, and waist/height r=0.50, all p<0.001) and negatively with MCH (particularly BMI r=-0.15 p=0.018, WC r=-0.14 p=0.028). CRP correlated positively with RBC (r=0.20 p=0.002) and negatively with MCH (r=-0.24 p<0.001). There were no associations between anthropometric measurements and haemoglobin, although, a positive association with RBC, particularly with waist/height (β=0.69, p=0.003) and waist/hip (β=0.59, p=0.046) was observed. All measures of adiposity were associated with CRP, particularly waist/height (β=4.29, p<0.001) and waist/hip (β=3.98, p<0.001). BMI (β=0.02 p=0.035), weight (β=0.007 p=0.043) and waist/height (β=1.30 p=0.036) were associated with unadjusted SF. BMI (β=–0.06, p=0.018), WC (β= -0.02, p=0.028) and waist/height (β= -3.16, p=0.041) were negatively associated with MCH.
We report a negative impact of adiposity on iron status that presents an increased risk for the development of anaemia, particularly for those who may become pregnant. Regardless of BMI, UK women have a high prevalence of low iron stores, and this would not be detected by current routine anaemia screening.
Conflicts of interest: The authors declare that there are no conflicting interests.
Funding: PhD scholarship from Ulster University.
Jennifer O’Mara1,Ioana Vlad1, Kate Oldridge-Turner1, Arnfinn Helleve2, Giota Mitrou1, Knut–Inge Klepp2, Kate Allen1, Rebecca Taylor1.
1World Cancer Research Fund International, London, United Kingdom
2Norwegian Institute for Public Health, Oslo, Norway
📌 Allocation: Poster (Board No. 38)
Nutrition and physical activity policies are key to creating environments where population health and prevention of obesity-related non-communicable diseases is prioritised. To hold national governments accountable in developing measures which support this, the NOURISHING and MOVING policy indexes were created to assess nutrition and physical activity policy, respectively. They provide an at-a- glance assessment on the policy status in 30 European countries, including in England, Scotland, Wales, and Northern Ireland. Nutrition and physical activity policy actions were identified through a comprehensive scan with a set methodology. Only national level policies were targeted, which include UK-wide and home nation policies. The policy actions were benchmarked using evidence-informed, aspirational attributes that assess the quality of policy design. The NOURISHING policy index shows that most action is being taken across all home nations in nutrition labelling, reformulation, and public awareness. Food marketing and advertising restrictions receive a fair assessment across the board and need improving. Across all home nations, least action is seen in ensuring coherence between food supply chains and health (Northern Ireland receives the highest assessment fair) and creating a healthy retail and food service environment, where England and Scotland receive a moderate assessment.The MOVING policy index finds best assessments for actions targeting physical activity in schools and the community. There are varied results across home nations for physical activity in the workplace, public communication, and counselling in healthcare settings. Northern Ireland is the only home nation with no action on physical activity in the workplace. Home nations receive mostly a fair assessment on policies targeting the active environments, including active design for built environments, and infrastructure for public and active transport. The NOURISHING and MOVING policy indexes show that key weaknesses in policy actions focus on structural policies in all home nation countries. These include policies on ensuring coherence between health and food systems, and developing infrastructure for active environments. Greater focus on these areas should be given by policymakers, researchers, and civil society to inform advocacy for, and design of, nutrition and physical activity policies for obesity prevention.
Conflicts of interest: This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 774210. This document reflects only the authors’ views and the European Commission is not responsible for any use that may be made of the information it contains.
Funding: The “Confronting Obesity: Co-creating policy with youth (CO-CREATE)” project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 774210 (https://www.fhi.no/en/studies/co-create/). All authors and their institutions report grants under this agreement and have declared their conflict of interest.
Sophia Bird 1
Obesity Prevention and Nutrition Team, Health Improvement Division, Public Health Wales, Wales
📌 Allocation: Poster (Board No. 39)
Whole Systems Approaches (WSA) are gaining popularity within public health as a more appropriate way to address complex public health issues such as obesity prevention, physical activity promotion or mental health and wellbeing. However, capturing change within the system is difficult and a variety of evaluation tools are needed, including those that can be used by practitioners with limited research and evaluation resource to draw upon. This abstract aims to describe the piloting of a real world tool for data capture of decision points and their intended and unintended consequence, both formal and informal, on a timeline. Building on the Ripple Effects Mapping approach (Nobles et al, 2022) a tool was developed within the Healthy Weight Whole Systems Approach in Wales, to enable system practitioners to regularly capture decisions and their consequences. The tool was designed to map their actions and observed impacts both intended and unintended. A template was developed with a key, showing colour and shapes, to distinguish different types of actions, such as whether formal or informal interactions, strategic or operational. Two system lead teams agreed to trial the tool over a 3 month period. This involved monthly local team meetings to review and log the previous month’s main activities. At the 3 month review the feedback suggested that the tool was proving useful in capturing expected and unexpected activity and outputs. There was agreement to continue the trial and another local system team came on board. The 6 month review confirmed that the tool holds promise for capturing planned activity and the intended outputs or outcomes, but also provides an opportunity for capturing unintended activity. It also appears to demonstrate the importance of developing relationships with wider stakeholders, building connections that develop into levers for intervention in the longer term. Other system lead teams in Wales are now trialling the tool too. In conclusion, LIUC holds promise as a practical tool for those working within complex public health programmes, to capture some of the intended and unintended consequences of actions within their work programme and the longer term value of engagement.
Conflicts of interest: none
Funding: Welsh Government to PHW for implementing a Whole Systems Approach across the nation
Penny R. Breeze 1, Katharine Pidd 1, Daniel Pollard 1, Chloe Thomas 1, Julia Mueller 2, Amy L. Ahern 2, Simon J. Griffin 2, Alan Brennan 1
1. The University of Sheffield, Sheffield, UK
2. University of Cambridge, Cambridge, UK
📌 Allocation: Poster (Board No. 40)
Value of Information analyses (VoI) can be used to assess the cost effectiveness of research projects. VoI uses health economic modelling techniques to help determine the value to society of collecting data and can inform trial design. SWiM is an online weight maintenance intervention based on acceptance and commitment therapy (ACT) delivered to adults who have recently completed a behavioural weight loss programme. Following a feasibility study, we aimed to evaluate the value of commissioning a randomised controlled trial (RCT) to assess the effectiveness of SWiM. Two expert panel workshops were conducted to specify unknown treatment effect parameters (weight and HbA1c) after 12 and 24 months, using elicitation techniques, and supporting evidence from the 6 month SWiM feasibility study, meta-analysis of weight maintenance interventions, and data from related weight loss trials. We used the School of Public Health Research Diabetes prevention model to evaluate the lifetime National Health Service costs, and Quality Adjusted Life Years discounted at 3.5%. Weight-related health consequences are simulated conditional on trajectories for weight and HbA1c. The incremental net benefit of the intervention was calculated assuming a cost-per-QALY threshold of £20,000, to describe efficient allocation of resources for the NHS. Uncertainty in treatment effects, costs and health-related quality of life were incorporated in probabilistic sensitivity analysis. The VoI analysis estimated the societal value of reducing the uncertainty from collecting data in future RCTs. The expert panel specified treatment effect parameters for SWiM indicating that the intervention is likely to delay weight regain following weight loss. The elicited treatment effect at 12 and 24 months was considered unlikely to lead to faster weight gain compared with standard care. The VoI analyses indicated that uncertainty in the treatment effectiveness parameters have a sizeable impact on the overall uncertainty in incremental net benefit and further research to collect data to inform these parameters would reduce this uncertainty. Weight maintenance interventions have the potential to improve long-term health outcomes. Further research to evaluate SWiM would be an efficient use of resources. Value of information analyses can help to improve the design of trials to support future decision-making.
Conflicts of interest: AJH has consulted for Slimming World. JM is a Trustee for the Association of the Study of Obesity (unpaid role). ALA and SJG are chief investigators on two publicly funded trials where the intervention is provided by WW at no cost outside the submitted work. ALA is a member of the Scientific Advisory Board for WW.
Funding: This research was funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Reference Number RP-PG-0216-20010).
Katharine Pidd 1, Penny R. Breeze 1, Daniel Pollard 1, Chloe Thomas 1, Julia Mueller 2, Amy L. Ahern 2, Simon J. Griffin 2, Alan Brennan 1
1. The University of Sheffield, Sheffield, UK
2. University of Cambridge, Cambridge, UK
📌 Allocation: Poster (Board No. 42)
While weight loss is a well known method of improving glucose control for people with type 2 diabetes, trials have concentrated on intense weight loss interventions, like surgery or formula diets. We propose a modelling framework to evaluate the cost-effectiveness of group-based weight management interventions in people recently diagnosed with type 2 diabetes. The School of Public Health Research (SPHR) Diabetes Treatment model was updated to evaluate the lifetime NHS costs and Quality Adjusted Life Years (QALY), discounted at 3.5%. This individual-level model simulates a representative population sample with newly diagnosed diabetes using baseline data from the trial and summary statistics from primary care records. The model estimated diabetes-related health outcomes using the UK Prospective Diabetes Study (UKPDS) Outcomes Model 2 risk equations, metabolic risk factor trajectory equations, and additionally simulates osteoarthritis, colorectal cancer, and breast cancer conditional on Body Mass Index. The UKPDS outcomes model is known to over-predict major long-term health outcomes in this population. Therefore, approximate Bayesian computation was used to calibrate incidence of Myocardial Infarction and Stroke events to a 10-year follow-up of ADDITION-Europe. This model will be used to evaluate the cost-effectiveness of the Glucose Lowering through Weight management (GLoW) trial (N=577). The GLoW trial evaluated the effectiveness of a tailored diabetes education and weight loss intervention (DEW), commonly known as Weight Watchers (WW), against a standard diabetes education program (DESMOND) in adults diagnosed with type 2 diabetes within the past 3 years. Average difference in HbA1c and BMI at 12 months between the DEW and DESMOND will be predicted from trial data. The duration of weight maintenance will be estimated from long-term follow-up of other weight management trials. The simulation generates a natural history for a population with newly diagnosed type 2 diabetes. Calibration to the ADDITION data reduces the incidence of MI and Stroke, and leads to a 10 year mortality rate of 16%, compared with 21% without calibration. The model can be used to evaluate weight loss interventions in this population.
Conflicts of interest: AJH has consulted for Slimming World. JM is a Trustee for the Association of the Study of Obesity (unpaid role). ALA and SJG are chief investigators on two publicly funded trials where the intervention is provided by WW at no cost outside the submitted work. ALA is a member of the Scientific Advisory Board for WW.
Funding: This research was funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Reference Number RP-PG-0216-20010).
William Goodman 1, Phillippa Lally 2, Abi Fisher 3, Rebecca J Beeken 1
1 University of Leeds, Leeds, UK
2 University of Surrey, Surrey, UK
3 University College London, London, UK
📌 Allocation: Poster (Board No. 43)
Obesity and weight gain after a cancer diagnosis are associated with poorer outcomes. The World Cancer Research Fund therefore recommends that those LWBC maintain a BMI < 25, and avoid weight gain. The current study aimed to explore the factors associated with receipt of, and interest in weight management advice as well as engagement in existing weight management programmes among people LWBC affected by overweight and obesity. Participants were living with or beyond breast, prostate or colorectal cancer and had self-reported height and weight as part of the “Health and Lifestyle After Cancer Questionnaire”. Additional items asked whether they had received advice on losing weight from a healthcare professional since diagnosis, whether they were interested in receiving weight management advice, whether they were currently enrolled in a lifestyle programme, and whether they believed maintaining a healthy weight was important for preventing cancer recurrence. Of 3,456 participants affected by overweight and obesity (BMI ≥ 25), a minority (23%) had received weight loss advice, and only 4% were currently enrolled in a weight management programme. Most were interested in advice (71%) and believed maintaining a healthy weight was important for preventing cancer recurrence (67%). After multiple imputation and adjustment for confounders, logistic regression results suggested those who reported receiving advice were more likely to be interested in receiving advice (Odds Ratio (OR) 1.68; 95% Confidence Interval (CI)1.30,2.18) and to be enrolled in a weight management programme (OR 1.60; 95%CI 1.07, 2.40). Those who believed maintaining a healthy weight was important for preventing cancer recurrence were also more likely to be interested in weight management advice (OR 1.47; 95%CI 1.33, 1.62) and to be enrolled in a programme (OR 1.57; 95%CI 1.25, 1.99). These results highlight a need for healthcare professionals to offer weight management advice more broadly to their patients affected by overweight and obesity, and to ensure that existing weight management programmes are acceptable to and meeting the needs of those LWBC. Information about the role of excess weight in cancer may encourage individuals to engage with programmes, but must be delivered in a sensitive, non-stigmatizing way.
Conflicts of interest: None
Funding: Cancer Research UK (grant numbers C43975/A27498 and C1418/A14133)
Adrian Brown*,1,2, Siri Steinmo* 2,3, Dipesh Patel 1,2,4, Jonathan TC Kwan 2,5, Laura Falvey 2, Ling Chow2, Laurence Dobbie 7, and Barbara McGowan 2,7
*Joint first authors
1.University College London, London, UK
2.Reset Health Ltd, London, UK
3.University College London Hospital, London, UK
4.Royal Free Hospital, London, UK
5.Darent Valley Hospital, Kent, UK
6.Broomfield Hospital, Chelmsford, UK
7.Guys & St Thomas’s Hospital, London, UK
📌 Allocation: Poster (Board No. 44)
Introduction.
Binge eating disorder (BED) is higher in people seeking weight loss interventions, with 9-29% reporting binge episodes. Data suggests that eating disorder (ED) risk increases in people following restrictive diets, with increased restrained eating increasing BED risk. Limited data exists on binge eating or eating behaviour in people following time restrictive eating (TRE). Reset Health is a digitally-enabled TRE programme for people living with obesity, T2D, and other complications. This service evaluation assessed the impact of the Reset Health programme on eating behaviour and binge eating.
Method.
660 members enrolled (mean age 47.5±10.1yrs, mean BMI 35.0±5.7kg/m2; 58.9% White Ethnicity). Eating behaviour was assessing using Binge Eating Scale (BES) and Three Factor Eating Questionnaire (TFEQ). Mean BES score was 14.7±8.4, mean TFEQ score 45.0±13.6, subscale for TFEQ scores; Cognitive restraint, 2.24±0.57, emotional eating 2.32±0.63 and uncontrolled eating 2.65±0.91. Members were supported on a TRE, low-carbohydrate, moderate protein plan delivered by clinicians and mentors with dietary guidance, goal setting, feedback, and social support. Data were analysed at 12-months of the 82 completers with completed data and reported using mean±SD.
Results.
Members lost a clinically significant amount of weight 12-months, 9.0±7.0kg respectively (p<0.001). Binge eating scale significantly reduced by 4.5±7.0 (p=0.006). Total TFEQ score reduced by 3.2±12.5 (p=0.192). Cognitive restraint score increased by 0.37±0.64 (p=0.006) while uncontrolled eating and emotional eating reduced by 0.34±0.44 (p<0.001) and 0.30±0.76 (p=0.06) respectively.
Conclusions.
These results overall show that eating behaviour and binge eating risk are not negatively impacted in in members engaging in a clinically led, digitally-enabled TRE programme. Indeed, a modest reduction in disordered eating behaviours was observed. Of importance is that binge eating behaviour and uncontrolled eating improved despite restraint increasing, suggesting that in a supported environment TRE does not increase risk for onset of eating pathology and can be effective and safe.
Conflicts of interest: AB, SS, DP, JK, BM are on the medical advisory board and are shareholders in Reset Health. LC, LF are employed and are shareholders at Reset Health.
Funding: None
S.C. Lennie 1, A. Hall 2, T.G. Nguyen 1, A. Boath 1, L. Vale 1, M.D. Teare 1, N. Heslehurst 1
1 Newcastle University, Newcastle upon Tyne, UK
2 Robert Gordon University, Aberdeen, UK
📌 Allocation: Poster (Board No. 45)
Objective anthropometric measurements have been used to estimate central adiposity and predict risk of morbidity and mortality, although their implementation at scale is often challenging due to variability in diurnal variation, accuracy and precision of instruments, adherence to gold standard protocols, the anthropometrist’s technical capacity, and the methods of data recording. Subjective methods for assessing body shape, such as photographs, silhouettes, and figure rating scales are low-cost alternatives, and have been extensively used in body image research, but limited information is available on their use in disease risk identification. Previous authors have highlighted ethnicity may be implied via facial and body features, and therefore tools may not transfer between population groups. Additionally, the inclusion of clothing items may distract from body shape or be useful for cultural sensitivity. This scoping review systematically identified the available visual subjective body shape assessment tools for assessing regional distribution of body fat, specifically for adult females, and their characteristics. MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science were searched using a comprehensive search strategy focussing on two main facets: body shape and assessment tools, with no language restrictions. After deduplication, 12,332 articles were screened, and 232 records were considered potentially eligible for data extraction. Preliminary results from 167 included studies identified 80 tools. Seventeen identified tools were variations (number of images/shapes, ethnicity) of 9 ‘original’ tools, and one tool was unavailable. Studies utilised tools to explore body image or shape attractiveness, satisfaction, or distortion (74.3%), health/ disease risk (14.4%), subjective tool development/ validation (12.6%), clothing/fashion (5.4%) or other (4.1%). Of 79 available tools, scale types were classed as figural (39.2%), photographic (21.5%), silhouette (15.2%), figural/ scanned image with shape overlay (6.3%), computer generated mannequins (5%), shapes (3.8%), somatograph (1.3%), and 7 tools were unclassified. The median number of body shapes used within tools was nine. Facial features were apparent in 34.1% tools, and 29.8% of 57 applicable tools implied nakedness. Reviewed literature highlights large variation in assessment tools, and primarily focussed on body attractiveness, satisfaction, and distortion. Further investigation into the subjective assessment of regional body fat distribution for disease risk identification is required.
Conflicts of interest: None
Funding: None
Padraig McQuaid 1, Gemma Jaggard 2, Dr Sravan Thondam 3.
Liverpool University Hospital Foundation Trust ( Aintree Hospital) UK, Padraig McQuaid
Liverpool University Hospital Foundation Trust ( Aintree Hospital) UK, Gemma Jaggard
📌 Allocation: Poster (Board No. 46)
NICE technology appraisal (December 2020) recommends the use of Liraglutide for the treatment of obesity in adult patients with pre-diabetes and cardiovascular risk factors attending a specialist multidisciplinary tier 3 weight management service.
LUHFT (Liverpool University Hospitals Foundation Trust) provides a specialist tier 3 weight management service for Merseyside and surrounding areas. The service is a consultant led, MDT service, consisting of Dietitians, physiotherapists, Occupational therapists, psychologists, and support services.
Since March 2021, we have successfully integrated a dietitian - led Saxenda clinic into the weight management pathway. Currently, we have 125 patients underway within this pathway, with an additional 100 due to start, later in 2023. We run two weekly dietitian clinics with prescribing and side effect management support from a Consultant Endocrinologist (1 x hour weekly).
Patients must achieve a minimum 5% weight loss at Week 16 and sustain this weight loss, to be eligible for a repeat prescription of Saxenda, up to a maximum period of 2 years.
The objective is to determine the effectiveness of the Saxenda clinic at Year 1, in terms of weight loss and attendance, with emerging baseline and Year 1 biochemistry marker comparison.
A retrospective audit was carried out to examine weight loss at baseline, 6 months, and 12 months.
There are 125 patients who started on Saxenda in Year 1.
104 patients (83.2%) remain on Saxenda, having surpassed, and sustained >5% weight loss.
14 patients (11.2%) achieved <5% weight loss and were discharged from the Saxenda clinic.
5 patients (4%) experienced significant side effects (nausea, diarrhoea, and vomiting) and were withdrawn.
2 patients (1.6%) had significant adverse events requiring further investigations and medical treatment.
Mean weight loss at 6 months is 8.11%, with mean BMI at 6 months reducing from 53.09 to 48.67 kg/m2.
The first 10 patients to reach 1 Year on Saxenda had a reduction in HbA1c of 20.16% (47.16 – 38.1 mmol/mol)
The clinic attendance rate was 97%.
The Saxenda clinic has a low DNA rate and provides an effective weight loss intervention that significantly reduces HbA1c and T2DM risk in a Tier 3 Weight management cohort.
Conflicts of interest: No conflict of interest
Funding: I hope to secure funding from the Therapies budget within LUHFT.
Tania Griffin 1, Jemima Cooper 1, Cathy Griffiths 1, Georgina Wort 1, Fiona Gillison 1, Nick Townsend 2, Harry Rutter 1
1. University of Bath, UK
2. University of Bristol, UK
📌 Allocation: Poster (Board No. 47)
The WHO Europe Child Obesity Surveillance Initiative (COSI), established in over 40 countries, collects height and weight measures with children aged 6-9 years alongside information on their physical activity and eating behaviours reported via a parent completed questionnaire. In England, the National Child Measurement Programme (NCMP), similarly collects height and weight measures but with children from a differing age group (4-5 and 10-11 years). The aim of this study was to explore the feasibility of a representative sample of Local Authorities (LA’s) integrating an additional measurement year into the NCMP allowing England to join COSI. Online semi-structured interviews were conducted with key-stakeholders who would be involved in COSI delivery were it to be introduced. Thematic analysis was conducted using the framework method. Nineteen interviews were conducted with 27 participants, including representatives from WHO Europe, four countries participating in COSI, OHID, and public health teams across eleven LA’s. Two main themes were identified related to the introduction of COSI: (1) Potential benefits (2) Logistics and practicalities. Data allowing for comparison of childhood obesity rates in England to COSI countries, an additional child measurement point to prompt earlier intervention if required, and the parent completed questionnaire (providing contextual information related to physical activity and diet) were seen as key positives. There was strong feeling from participants that additional data collection should lead to action and not act solely as additional surveillance. Representatives from countries already participating in COSI spoke of the opportunities it provides including networking, and the use of data to inform health policies and allocation of resources. Pragmatic considerations (e.g., staff time and costs, school logistics) were discussed by LA representatives with notable variation related to the predicted resourcing which would be required to enable an additional measurement year into the NCMP. It was clear that were COSI to be introduced, schools and parents should be provided with clear information using appropriately sensitive language. Overall, there were perceived benefits of England joining COSI, alongside acknowledgment of potential challenges. Additional data collection would need a clear rationale presented to schools and parents, be well resourced and lead to visible action.
Conflicts of interest: None
Funding: University of Bath UKRI Policy Research Fund
Rana Conway1, Ivonne Derks1, Florence Sheen1, Andrew Steptoe1, Clare Llewellyn1
1 University College London, London, UK
📌 Allocation: Poster (Board No. 48)
In recent years there has been a significant increase in the types of food marketed as healthy snacks for infants and young children, despite many of these being energy dense and containing high levels of free sugar and salt. As well as providing nutrition, parents see commercial snacks as playing a non-nutritive role, such as keeping children occupied and enabling them to take part in family rituals. This study aimed to explore the determinants of parents’ infant snack choices and assess the impact of removing specific ‘health halo’ messaging on parents’ perceptions of healthiness and intentions to purchase. Participants were UK parents of children aged 6-23 months. An independent parallel mixed methods design was employed for complementarity. An online experiment was conducted with parents (n=1237) to explore children’s snack intake and parents’ priorities for selection. Participants were randomised to view mock infant snack labels with or without health messaging. Perceived healthiness and purchasing intentions were measured. Chi-square tests were used to compare conditions. To explore factors shaping parents’ infant snack choices in more depth and understand their perceptions of common infant snacks, an independent sample of parents (n=25) took part in focus group interviews. Parents completing the online experiment indicated that infants consumed a mean (SD) of 2.5 (1.4) snacks/day. Most infants (87.5%) consumed some commercial infant snacks. When choosing snacks, parents reported prioritised health and development, as well as wanting snacks containing natural ingredients, fruit and vegetables, no additives and no sugar. Removing a single health halo message resulted in minor differences in healthiness and purchase ratings. For example, 16.8% of parents strongly agreed a product labelled ‘packed with real fruit’ was healthy compared to 12.3% viewing the product without this message (X2(6)=12.932, p=0.04). Focus group participants described complex and competing factors shaping their infant snack choices, including brand identity, social norms, and messaging on commercial snacks suggesting equivalence to fresh fruit and vegetables. Factors determining parents’ infant snack choices aligned closely with common marketing messages, for example highlighting fruit content. Legislation restricting the use of health halo messaging on infant snacks could support parents to make healthier choices.
Conflicts of interest: none
Funding: This research is funded by the National Institute for Health and Care Research, as part of the Obesity Policy Research Unit.
Rana Conway1, Ivonne Derks1, Florence Sheen1, Andrew Steptoe1, Clare Llewellyn1
1 University College London, London, UK
📌 Allocation: Poster (Board No. 49)
Many infants and young children in the UK exceed national guidelines for energy and free sugar, increasing their risks of excess weight gain. Baby foods are frequently marketed as healthy despite containing high levels of free sugar. This study aimed to (i) assess the impact on parent’s feeding choices of adding a high sugar indicator to infant food labels and (ii) explore parent’s beliefs about the sugar content of infant foods. An online experiment was conducted with UK parents of children aged 6-23 months (n=1237). Parents were randomly assigned to one of three groups. Each group viewed three varieties of infant dessert, all of which displayed either: (i) no information about sugar; (ii) high sugar indicators; or (iii) high sugar indicators plus the message ‘contains natural sugar’. Chi-square tests were used to compare conditions. Parents could choose an infant dessert or indicate none chosen. The experiment was repeated with infant snacks. Parents then indicated their level of agreement with statements about the sugar content of infant foods. To better understand the way sugar labelling is used, in-person focus group interviews were conducted with an independent sample of parents of children aged 6-23 months (n=25). In the online experiment, infant desserts displaying a high sugar indicator were chosen by fewer parents (68.3%) than identical desserts without a high sugar indicator (95.4%), and the impact of adding a high sugar indicator was smaller when ‘contains natural sugar’ was also shown, with 75.0% of parents choosing a dessert (X2(2)=101.0004, p<0.001). Results were similar for infant snacks. Survey responses indicated most parents believed foods marketed as suitable for babies didn’t have added sugar (70.3%) and were low in sugar (63.5%). Most parents also believed that natural sugar in baby food wasn’t bad for babies (59.5%). Parents attending focus group interviews expressed mixed opinions about ‘natural sugar’, they wanted clearer sugar labelling and supported the use of a high sugar indicator. Most parents believed infant foods had a low sugar content. Adding a high sugar indicator to infant foods and removing ‘contains natural sugar’ could support parents to reduce their children’s intake of free sugar.
Conflicts of interest: None
Funding: This research is funded by the National Institute for Health and Care Research, as part of the Obesity Policy Research Unit.
Saksena Rhea 1 & 2 , Dahiya Aditya 2
1 - University of Oxford, Oxford, UK
2 - Harvard T H Chan School of Public Health, Boston, United States of America
📌 Allocation: Poster (Board No. 50)
Background: The Soft Drinks Industry Levy (SDIL), announced in the UK in 2016, aimed to reduce SSB consumption. A criticism is its economic regressivity as those with lower incomes pay a greater proportion compared to higher incomes. We use the Extended Cost-Effectiveness Analysis methodology to analyze the equity impact of the SDIL. Methods: We computed overall change in SSB consumption from the SDIL by income group and levy charges as a proportion of SSB expenditure per group. We considered averted cases of obesity and diabetes prevalence across income groups. We analysed averted direct and indirect costs due to reduction in health costs across income groups. Results: After introduction of the SDIL, additional SSB costs were £42,334,968 for the lowest income tertile, £26,238,564 for the middle tertile and £35,474,062 for the highest tertile. 87,500 overweight cases and 59,900 obesity cases were averted in the highest income tertile; 82,300 overweight cases and 47,700 obesity cases in middle tertile; and 145,300 overweight cases and 97,300 obesity cases in lowest tertile. Direct diabetes cost savings due to cases averted annually is £18.52 million with greatest savings of £8.18 million in the lowest income tertile, £6.29 million in the middle tertile and £4.1 million in the highest tertile. The indirect savings saved include the savings of reduced absenteeism is £24.16 million overall, with greatest savings in the lowest income tertile of £10.66 million, £8.2 million in the middle tertile and £5.3 million in the highest tertile. Pension savings were calculated to be £23.5 million, £18.1 million, and £11.7 million across income tertiles lowest to highest respectively. Savings due to reduced expenditure on social welfare were £8.4 million saved overall, with £3.75 million saved in the lowest income tertile, £2.88 million in the middle tertile and £1.86 million in the highest income tertile. Conclusion: We found that the distributional impact of these factors across income tertiles demonstrates that the SDIL is not regressive as is assumed with many SSB taxes. The net savings are greatest in those of the lowest income tertile, and the net costs are greatest in those of highest income tertile.
Conflicts of interest: None
Funding: Fulbright Commission and Kennedy Memorial Trust
Jordan D Beaumont 1, Rosie Wyld 1, Tina Reimann 1, Beverley O’Hara 2
1 Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB, UK
2 Leeds Beckett University, Woodhouse Lane, Leeds, LS1 3HE, UK
📌 Allocation: Poster (Board No. 51)
Obesity is a complex disease driven by factors largely beyond an individual’s control (e.g., genetics, environment). Despite this, attitudes towards people living with obesity (PLwO) typically encompass negative stereotypes (e.g., laziness, lack of self-discipline), often placing blame on the individual. In this ongoing work, we explore perceptions held around weight, and how these link with health and being “healthy”. Participants (n = 110 to date) completed an online survey comprising of demographic questions and validated questionnaires measuring experience of weight bias/stigma, views of PLwO, weight status, and physical activity. Participants viewed eight images depicting “healthy” (eating balanced meal, physical activity) and “unhealthy” (eating junk food, sedentarism) behaviours completed by individuals with healthy weight or obesity, and asked to describe what they see. Finally, participants were asked to report factors they believe contribute to good and poor health. Participants who self-identified as overweight or obese experienced greater number of stigmatising situations (z = 624, p < 0.001) and held more stigmatising views of themselves (z = 560, p < 0.001). However, stigmatising views of others, measured using validated questionnaires, were low across all participants. When measuring these views across image-based questions, comments were more negative if they depicted PLwO compared to healthy weight counterparts, regardless of the activity depicted (z = 233, p < 0.001). Comments to images of PLwO were more critical of the behaviour depicted (i.e., eating, physical activity) even where these are deemed “healthy”. In comparison, images of individuals with healthy weight often focussed on wider factors (e.g., social interactions, occupation). Participants’ views of good and poor health often centred around physical appearance; good health was linked with a slim or muscular build (associated with exercise), whereas poor health was linked with perceived larger body size and associated with general poor health (e.g., unhealthy diet, smoking, poor mental health). This data shows discrepancy in views of PLwO versus healthy weight. While quantitative data shows low stigmatising views, qualitative data identified clear bias; PLwO are consistently viewed more negatively even if they follow similar “healthy” behaviours as healthy weight counterparts. Addressing such discrepancies is important for eradicating weight-based stigma.
Conflicts of interest: None.
Funding: None.
Kath Williamson 1 & 2, David Blane 1, Eleanor Grieve 1, Mike Lean 1
1. NHS Lothian
2. University of Glasgow
📌 Allocation: Poster (Board No. 52)
People living with severe obesity (PLwSO) experience increased risk of functional disability, requiring specialist – often termed bariatric – equipment. Hospital staff commonly report difficulty accessing such equipment. Home health care for PLwSO is growing, yet equipment and adaptations used by community-dwelling PLwSO, including costs, are poorly documented. For a wider study in a Scottish local authority area, PLwSO known to community professionals consented to a home visit between February and December 2020, where an investigator-administered questionnaire included use of current medical equipment and housing adaptations. Care records were used to verify data. Local and published sources informed a micro-costing. Twenty-five individuals (15 women) participated, aged 40-87 (mean=62) years, BMI 40-77 (mean 55) kg/m2, 20 were housebound. One participant had sourced equipment privately, whilst 24 (96%) had equipment or home adaptations provided by health or local authority services. Nineteen participants (76%) used specialist equipment to accommodate larger body size or weight. Total equipment costs were £114,637 ranging from £0 to £25,495 by participant (mean £4,585 for all, median £2,367). Ten (40%) participants had individual costs >£5,000. The most frequently used equipment were rise-recline chairs, aiding sit-to-stand and lower limb elevation, with 20 chairs (2 private) between 19 participants. Sixteen chairs were heavy duty or custom made, costing up to £5,190. Mean cost was £2,241, >3 times greater than standard chair costs. Twelve participants had hospital beds. Nine had bariatric beds at a mean cost of £1,824, nearly 4 times more than standard bed costs. Housing adaptations ranged from simple bathroom grab rails to full-scale house extensions involving architects and builders. Total adaptation costs were £134,194, ranging from £0 to £30,576 by participant (mean £5,368, median £412). Twelve (48%) participants had individual costs >£5,000. Wet floor showers were the most common housing adaptation, accessed by 16 participants. PLwSO commonly use specialist chairs and beds to enable activities of daily living at home, with associated significant costs. Further work is needed regarding usage and availability, to inform evidence-based decision making about person-centred care, effective resource utilisation, service development, staff training and health economic costing of obesity.
Conflicts of interest: All authors declare no conflicts of interest.
Funding: All Saints Educational Trust (ASET) funded part of this research.
Annina Halsall 1, Dr. Sophie Edwards 2, Professor Paul Gately 3
1 - MoreLife (Ltd), Greater Manchester, UK
2- MoreLife (Ltd), Greater Manchester, UK
3- Leeds Beckett Obesity Institute, Leeds, UK
📌 Allocation: Poster (Board No. 53)
MoreLife Tier 3 weight management service offers Orlistat and Liraglutide as treatment options to those that meet NICE eligibility criteria. As part of the medication pathways individuals receive comprehensive medical and dietetic consultation with the specialist team. For clients to continue on Liraglutide or Orlistat they need to demonstrate 5% weight-loss after 12 weeks at full dose. This evaluation compares data to discuss if Orlistat is an effective treatment option considering the introduction of newer medication.
This review compared data from 41 clients prescribed Liraglutide with 41 clients prescribed Orlistat who reached the point of weight-loss review, per NICE guidance, between April 2022 and April 2023.
For individuals treated with Liraglutide 4.8% of participants stopped treatment due to undesired side effects and 2.4% discontinued due to poor attendance. Comparatively, 14.6% of clients stopped Orlistat due to side effects and 12.2% due to attendance. At review, 9.7% clients were advised to stop taking Orlistat due to a new medical diagnosis considered adverse to treatment and 4.9% were not compliant with the recommended dose. On the Liraglutide pathway 37 clients (90.2%) reached the point of review were compliant with both medication and attendance, from this 92.1% achieved the 5% weight-loss goal. 24 clients (58.6%) were compliant on the Orlistat pathway and 54.2% of those had achieved the 5% recommendation. For individuals who continued on the medication pathway the mean weight loss was -10.9kg and -8.4% (Liraglutide) verse -6.3kg and -5.7% (Orlistat).
These results outline a significant difference in user compliance, frequency of side effects and weight-loss between the two medications. However, Orlistat has lesser criteria for eligibility comparatively thus preferable where Liraglutide is not appropriate. Additionally the cost of Liraglutide is around nine times higher than the cost of an Orlistat prescription. A recent systematic review on Orlistat outlines that 21% of clients achieved 5% weight-loss. Clients at MoreLife have more success (58.6%) which could be corelated to with robust medication pathway offering the addition of dietary assessment which may not be provided in primary care. Thus, Orlistat should be considered as an cost-effective treatment option for weight-loss with the correct support.
Conflicts of interest: All authors are affiliated with MoreLife Tier 3 service from which the data was collated.
Funding: NHS approved anti-obesity medication in MoreLife is commissioned by the integrated care board. No additional funding was received for the purpose of this evaluation.
Dunla Gallagher 1, Eleni Spyreli 1, Annie S Anderson 2, Sally Bridges 3, Norelle Calder-MacPhee 4, Chris R Cardwell 1, Elinor Coulman 5, Kirsty Crossley 3, Stephan U Dombrowski 6, Corinne Feuillatre 1, Caroline Free 7, Pat Hoddinott 4, Alice Ivory 7, Ben Karatas 5, Rihab Kazi 3, Frank Kee 1, Clare B Kelly 1, Marianne Lind 4, Cliona McDowell 8, Emma McIntosh 9, Lynn Murphy 8, Emmanuela Osei-Asemani 7, Helen Stanton 5, Jayne V Woodside 1 and Michelle C McKinley 1, on behalf of the Supporting MumS (SMS) research team.
1. Queen’s University Belfast, Belfast, UK.
2. Ninewells Medical School, Dundee, UK.
3. Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
4. University of Stirling, Stirling, UK.
5. Cardiff University, Cardiff, UK.
6. University of New Brunswick, Fredericton, Canada.
7. London School of Hygiene & Tropical Medicine, London, UK.
8. Northern Ireland Clinical Trials Unit, Belfast, UK.
9. University of Glasgow, Glasgow, UK.
📌 Allocation: Poster (Board No. 54)
Major physiological, psychological and social change is typical of the postpartum period. This poses challenges for engaging with weight management interventions, particularly for disadvantaged groups who are less likely to be represented in health research, creating a potential to increase health inequalities. Supporting MumS (SMS) is a United Kingdom (UK)-wide randomised controlled trial (RCT) that aims to examine the effectiveness of an automated text message intervention to support postpartum weight management.
A two-arm, multi-centre trial recruiting women, within two years of giving birth, with a BMI ≥25 kg/m2, from five sites across the UK. Recruitment sites were selected to target geographical areas of ethnic and socioeconomic diversity. Recruitment was via community and NHS pathways and the Born in Bradford Better Start (BiBBS) cohort study. Preliminary descriptive analysis examined the numbers screened for eligibility and randomised, participant characteristics and data on how women heard about the study.
Over a 12-month period, 2,199 women expressed an interest in taking part (Belfast n=568, Scotland n=367, Cardiff n=601, Bradford n=277, London n=386), 1,221 women (56%) were screened for eligibility and 892 women (41%) were randomised (Belfast n=200, Scotland n=150, Cardiff n=159, Bradford n=194, London n=189). Over 35% of the women screened were of non-white ethnicity. The majority of those screened/recruited heard about the study through social media including sponsored posts (50.2%/50.7%), followed by parental groups (17.5%/19.0%), friends/family (6.9%/7.9%) and GP/health professionals (2.2%/3.0%). Approaches differed across sites (London: 94% recruited through community-based, face-to-face methods; Bradford: >40% recruited via BiBBS and associated community links). Overall, participant mean age and BMI was 33.1 (±5.1) years and 32.5 (±5.7) kg/m2, respectively. The recruited sample ethnicity is: White= 66.1%, Asian/Asian British= 16.7%, Black/Black British/Caribbean/African= 11.0% and Other= 6.1%, with the largest proportions of women from Asian and Black groups recruited from Bradford and London sites, respectively. Household income distribution is: <£10k-30k= 33.9%; £30-60k= 35.1% and >£60k= 31.0%.
An ethnically and socioeconomically diverse sample of women was recruited using varied approaches and by including study sites with links and access to under-served populations. Retention and intervention engagement in different groups of women will be examined in the ongoing SMS trial.
Conflicts of interest: Emma McIntosh is a member of the National Institute for Health Research (NIHR) Public Health Research (PHR) Funding Board. Caroline Free is a member of the Health Technology Assessment (HTA) Funding Committee. Frank Kee was a member of the NIHR PHR Research Funding Board and PHR Prioritisation Group (2009–19). Dunla Gallagher received funding from Slimming World (Miles-Bramwell Executive Services Ltd, Alfreton, UK) for work conducted prior to her involvement in this study (2013-2017).
Funding: The National Institute of Health and Care Research (NIHR) Public Health Research (PHR) Programme (NIHR131509).
Anne Moorhead1, Huiru Zheng1, Felix Engel2, Binh Vu2, Mattias Hemmje3, Louise Lynch1, Raymond Bond1, Haiying Wang1, Micheal McTear1
1Ulster University, Belfast, Northern Ireland
2FTK - Forschungsinstitut für Telekommunikation und Kooperation e.V.,Wandweg 3, D-44149 Dortmund, Germany
3GLOBIT GmbH, Barsbüttel, Germany
📌 Allocation: Poster (Board No. 55)
Obesity care is an urgent global health related challenge. This research is part of the interdisciplinary European STOP project that aims to establish a data and knowledge ecosystem as a basis for the STOP Portal to enable healthcare professionals in decision support, and persons with obesity in analysis and feedback of health information to optimise healthy nutrition. The aim of this current randomised controlled trial (RCT) was to determine the effectiveness of the newly developed system for adults with overweight and obesity to lose weight. This was a pilot two-arm RCT: 1. intervention (n=15) and 2. control (n=15). All the participants were adults with overweight or obesity. The intervention group used the STOP Portal, while the control group did not use this system, no intervention. Participants were randomised into one of the two groups using a computer randomised programme. The primary outcome was percentage reported weight loss. Four data collection points for both the intervention and control groups at 1. baseline (month 0); 2. month 1; 3. month 2; and 4. month 3. Regardless, of what group the participants were in, their weight and height were recorded at each of these four data collection points. The STOP Portal collects the following data: physiological data, knowledge resources, biomedical data, self-reporting activity and food data. Ethical approval was obtained. A total of 30 adults registered for this pilot RCT and participated up to three months. The results clearly indicated that adults (18 years+) with overweight or obesity and were in the intervention group and using the STOP Portal significantly (P<0.001) lost body weight (kg; % weight loss; BMI). Thus the STOP Portal is significantly effective for participants losing body weight. However, not all the participants in the intervention group used the STOP portal but still lost some body weight, indicating that not all participants would use a tool such as the STOP Portal. In conclusion, this RCT showed that the STOP Portal has potential to be effective for adults with overweight or obesity to lose weight, especially for those who engaged with it. Thus digital technology can support obesity care.
Conflicts of interest: There were no conflicts of interest.
Funding: This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 823978.
Irena Cruickshank 1, Rob Andrews 1, Isy Douek 1, Rhodri King 1
Weight Management Department
Musgrove Park Hospital, Taunton
Somerset Foundation NHS Trust
UK
📌 Allocation: Poster (Board No. 56)
The provision of Tier 3 Weight Management (WM) services varies across the UK and many services have significant waiting times from initial referral. The use of digital technology for WM services is increasing in popularity, both commercially and within the NHS in an attempt to reduce disparities in provision.
We received funding to purchase 94 licences for a 6-month programme using a Liva Healthcare coaching app, to be offered to patients on our waiting list for a first appointment in the WM service. Patients were screened by a WM nurse specialist (to exclude patients with eating disorders, pregnancy, prior bariatric surgery of significant mental health problems) and provided with verbal and written information about the programme. Between 3rd Oct 2022 and 31st March 2023, 324 patients were approached, and 94 (10 male and 84 female) patients were referred (29%). By the end of May, 61(65%) had enrolled with the programme, 33 were discharged.
Reasons for discharge: app not downloaded ≥ 40 days (17), multiple cancelled appointments and no further activity ≥ 40 days (4), did not attend initial appointment (4); no appointment made within 40 days (3), patient request (2), did not attend more than 3 appointments (2), on another programme (1).
Of the 43 patients referred before 15th December 2022, half have been discharged and only one person completed the 6-month programme so far (out of potentially 15).
Approximately 80 hours of the WM nurse’s time was spent on the initial contact (screening referrals and contacting the patients). Further time was spent for follow up consultations, inputting patients to clinical systems, informing GPs and answering queries.
Outcome data regarding changes in weight and patient satisfaction for those referred to the 6-month programme are not available yet, so it is too early to make any conclusions. It is clear however, that screening patients on a WM waiting list is time consuming and patient engagement poor. Although a useful adjunct to weight loss for many patients, digital weight management programmes are unlikely to be the panacea for all.
Conflicts of interest: None
Funding: Funding received from a Grant from Novo Nordisk for the Liva Healthcare app licences
Funding received for a fixed term Weight Management Nurse post from Novo Nordisk
Midad Ali 1, Ian Macdonald2 and Moira Taylor3
1 Administration of Clinical Nutrition, King Abdullah Medical City, Makkah, Saudi Arabia and The David Greenfield Human Physiology Unit, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Nottingham, UK.
2 Emeritus Professor of Metabolic Physiology, University of Nottingham, Nottingham, UK.
3 The David Greenfield Human Physiology Unit, National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Nottingham, UK.
📌 Allocation: Poster (Board No. 57)
Recently, irregularity of meal pattern has been considered as a possible new risk factor for obesity and its associated consequences. The effect of an irregular meal pattern on carbohydrate and lipid metabolism has been considered in a limited number of studies, however, the impact on protein metabolism has not been addressed. The aims of this study were to investigate the effect of irregular meal pattern, compared with a regular meal pattern, on nitrogen balance and subjective appetite in healthy normal-weight females over a 7-day period. In a randomized crossover trial, 14 female with healthy normal weight (mean ± SD BMI: 20.4 ± 1.5 kg/m2) followed in period 1 either a regular (6 meals/day) or an irregular meal pattern (3- 9 meals/day). In period 2, participants followed the alternative meal pattern to that followed in period 1. The two (7-day) intervention periods separated by a wash-out period of 21 days. Nitrogen balance was calculated based on measuring of urinary urea nitrogen using daily 24-h urine samples. Subjective appetite ratings were recorded before and after each meal on day 7 during both intervention periods when 6 meals were consumed. Nitrogen balance between the two interventions was not significantly different (P=.091) over a 7-day period. Moreover, there were no significant differences in pre- and post- meal values between interventions in all appetite ratings (hunger, satiety, fullness, and prospective food consumption). The findings from the present study have indicated that the effect of meal pattern irregularity on nitrogen balance over 7-day period is not significant. With regard to subjective appetite, there were no changes in all appetite ratings with consuming a regular or irregular meal pattern which was inconsistent with previous studies. It would be of interest in future works to study overweight and obese individuals in the same protocol with restricted nitrogen content to make the findings applicable to a broader population and to conduct longer term studies.
Conflicts of interest: No conflicts of interest were declared by authors
Funding: King Abdullah Medical City in Makkah, Saudi Arabia
Clare H Llewellyn1, Rana Conway1, Francesca Solmi1, Ivonne Derks1, Florence Sheen1, Andrew Steptoe1, Dasha Nicholls2
1 University College London, London, UK
2 Imperial College London, London, UK
📌 Allocation: Poster (Board No. 58)
A focus of obesity public health messaging is making calorie information salient. As such, out-of-home sector calorie labelling regulations were introduced in England in 2022. Eating disorders (EDs) professionals and advocates are concerned that the focus on calories may inadvertently increase preoccupation with food, weight and shape, leading to increases in disordered eating behaviours and cognitions among vulnerable groups, including children and young people (CYP). Concern has been compounded by an increase in referrals for EDs among CYP in high-income countries over recent years. However, the specific impact of current obesity public health messaging on ED risk in CYP is not known. The Obesity Policy Research Unit is therefore undertaking research which aims to discern the range of weight and healthy eating messages that CYP are exposed to, and how these are understood, internalised, and acted upon. This will inform the development of inclusive public health obesity messaging that does not cause inadvertent harm to CYP who are living with, recovering from, or at risk of, an ED. The research involves Patient and Public Involvement and Engagement (PPIE), and qualitative and quantitative studies with CYP, parents and teachers. ~1000 CYP (aged 9-13) will be recruited via schools in urban and rural areas of England. A quantitative survey will establish their understanding of healthy eating and energy balance, and discern the messages they are exposed to (including both public health and non-government messaging) around weight, eating and body positivity. Qualitative research using focus groups will explore how CYP understand, interpret, and internalise messages around weight and healthy eating, and how these are acted upon. PPIE with CYP, parents, teachers, and individuals with lived experience of EDs will inform the research throughout, including recruitment materials, development of the quantitative survey, and the interview schedule for focus groups. EDs across the weight spectrum are increasing in prevalence among CYP in many high- income countries. A move towards making obesity public health messaging more considerate of CYP who are living with, or at risk of, an ED could have wide benefits and would support the healthcare principle of ‘first, do no harm’.