Improving quality of obesity management in primary care : implementation of a behaviour modification programme for weight loss in primary care : a prospective interventional study

Background: Cognitive behaviour modification programmes (CBT) have shown to be effective in treating obese patients, but difficult to implement in primary care setting. Objectives: We aimed to implement a CBT weight loss programme for overweight and obese adults into routine care of Swiss general practitioners network in cooperation with a community centre for adult education. Methods: Based on evidence reports, we choose an organisational intervention rather than addressing individual physician behaviour. A team of network physicians and scientists planned the intervention, a multidisciplinary core group of trained CBT weight-loss-instructors acted as the central element. To monitor the results we prospectively collected data for participant characteristics, weight change, self reported physical activity, and quality of life (SF-36) until 1 year of follow-up. Results: The CBT-programme for weight loss was implemented successfully. 25 courses, with 16 group meetings each, were initiated over a period of 3 years. Median weight loss after 1 year in a cohort of 190 participants was -4.0 kg (IQR: -1.5 to -7.5 kg). Changes in quality of life were modest, attrition rate was 25%. Conclusions: Based on an organisational change a CBT programme for weight loss is now available as an easily accessible therapeutic option for family doctors and their overweight patients as well as for overweight persons from the community