Nationwide competition to pilot new models of obesity support

Background: Specialist weight management services (SWMS) in the UK National Health Service (NHS) face long waiting lists and limited resources. Remotely-delivered SWMSs may support existing NHS services to increase access to treatment for patients living with obesity, however evidence of remotely-delivered services working to support NHS SWMSs in practice remains limited. Objective: This service evaluation explored the potential effectiveness, #feasibility and acceptability of Second Nature’s remotely-delivered SWMS for adults living with obesity referred from existing NHS SWMSs. Preliminary findings from the first phase (‘Preparing for weight loss’) of a three-phase remotely-delivered SWMS are presented. Methods: A total of 39 adults (age range 23–74 years, mean age 45.6, SD 12.1; 74% female) completed a 16-week intervention, following referral from NHS SWMS leads. Eligible participants were assessed by a multidisciplinary team and allocated to one of three interventions: 1) a psychologically informed app-based intervention, 2) a Dialectical behavioral Therapy (DBT)-based skills training group intervention and 3) one-to-one psychological support. Primary outcomes were weight change (kg) and percentage weight change following completion of the intervention. Secondary outcomes included psychological distress, emotional eating, health-related quality of life, physical activity, emotion regulation, intervention #feasibility and acceptability. Results: At 16-weeks, the mean weight change was -2.2 kg (SD 5.16), or -1.6% of body weight . Participants in the app-based intervention lost the most weight (-2.8kg), and participants in the one-to-one psychological support intervention lost the least weight (-1.3kg). Psychological distress reduced to below the clinical threshold (mean score 0.95, SD 0.62). Emotional eating behaviors and difficulties in emotion regulation also decreased (mean change scores -3.2, SD 6.4 and -11.6, SD 13.9, respectively). Health-related quality of life saw improvements in self-care, usual activities and anxiety/depression , while participants’ challenges with mobility and pain/discomfort remained unaffected. Subjective ratings of health status improved by 17.4%. There were no significant changes in physical activity levels, with most participants remaining ‘Inactive’ or ‘Moderately inactive’. Engagement with intervention sessions was high (93.7%) and attrition rate was 27.4%. Participants rated their satisfaction with the intervention at 9/10 and highlighted key benefits including improved mental wellbeing, healthier habits, and supportive coach relationships. Suggested improvements included greater scheduling flexibility, enhanced app functionality, and more accessible physical activity support. Conclusions: This preliminary service evaluation suggests that a remotely delivered SWMS has the potential to be effective, feasible and acceptable for NHS-referred patients in the UK. Changes observed across several key measures point to clinically significant benefits, reinforcing the potential of this approach. A full evaluation of all three phases of this service with a larger sample size is required to support these early findings.