The specialist weight management model of service provision
The service is provided in Plymouth by a specialised multi-disciplinary team consisting of specialist nurses, physiotherapists, dietitians, clinical psychologists and consultant endocrinologists supported by a team of clerical and support staff.
The programme commences with patients required to opt in to attend 2 mandatory Induction Sessions which provide an overview of the programme and an understanding of the commitment to behaviour change required. Patients are then required to request an assessment appointment with a Weight Management Specialist Nurse. This includes a biometric measure, medical, social and diet history. The patient can then opt for the group time and venue that is both most convenient for them and has places available. Additionally, all patients will have individual review appointments with the specialist nurse and other members of the team. The frequency and the professionals to be seen will be determined on an individual patient basis. All patients who are accepted onto the programme will have met the basic BMI criteria for bariatric surgery in Western Locality and bariatric surgery can be considered for some patients.
The service provided is person-centred and non-judgmental, with the aim of freeing patients up to develop their own internal resources. The programme is psycho-educational, encouraging patients to see themselves as adult learners who are responsible for and capable of deciding on and making their own lifestyle change. Therefore, we operate an ‘opt-in’ policy at a number of stages in the programme. The programme is based on a model that aims to increase people’s motivation which includes the following approaches – Motivational Interviewing, Cognitive Behavioural Therapy (including behavioural activation & cognitive restructuring), Mindfulness and Self-compassion.
The lifestyle interventions we provide comply with NICE Obesity Guidance CG043 (2006) and are multi-component, which include behaviour change strategies to increase people’s physical activity levels, and improve eating behaviour or quality of diet. It is delivered by healthcare professionals who have relevant competencies and specific training. Behavioural interventions are delivered with the support of appropriately trained professionals and include the following strategies, as appropriate for the person:
- self-monitoring of behaviour and progress
- stimulus control
- goal setting and problem solving
- ensuring social support (including our own support groups run by our patient volunteers)
- cognitive restructuring (modifying thoughts)
- relapse prevention and strategies for dealing with weight regain.
For patients aged 18+ years with BMI 35kg/m2 with co-morbidities or BMI 40kg/m2
Co-morbidities are defined as:
- Type 2 Diabetes
- Uncontrolled hypertension requiring 3 agents
- Patients whose hyperlipidaemia is uncorrected by maximum tolerated doses of statins
- Sleep apnoea
- Severe osteoarthritis e.g. require listing for joint replacement or in severe pain, uncontrollable with analgesics
- Patients with idiopathic intracranial hypertension
- Infertility in which weight is a barrier to therapy
- Known cardiovascular disease
- Non-alcoholic steatohepatitis
- BMI (Body Mass Index)
- BP (Blood Pressure)
- HbA1C (blood glucose)
- U & E (urea & electrolytes)
- FBC (full blood count)
- TSH (Thyroid stimulating hormone)
- LFT (liver function test)
- Patients not registered with a NEW Devon CCG Western Locality GP
- Patients under 18 years
- Pregnant women
- Housebound patients
- Patients who are unwilling or unable to participate in group programme (please assess suitability of Mental Health and Learning Disability patients and contact a member of the Weight Management team if required)
Tel: 01752 434623
Email: [email protected]
How to refer
Referrals should be made via DRSS or by letter to Clinical Lead, Sarah Hind.