Evaluation of weight management services provided by dietitians within a community trust
Abstract:Background: The British Dietetic Association has produced guidelines as to how dietitians should be trying to manage obesity, and locally within Leicestershire Nutrition and Dietetic Service dietitians have set up initiatives to improve obesity management Funding from the Department of Health made it possible to carry out an evaluation of the weight management services provided.
Method: A retrospective record card audit of overweight or obese patients who had completed an episode of care in a defined time period was carried out. In total 167 patient record cards were audited. The patient profile was characterized in terms of gender, age, body mass index (BMI) at start and end of treatment, source of referral and reason for referral. Information was collected on dietary targets set and achieved. A Patient Satisfaction Survey was sent to each patient at the end of the episode of care. Criteria set for successful weight loss was 5 kg or 5% starting body weight. Success in achieving dietary targets was defined as meeting > 50% of targets
Results: In total 50% (n = 83) of patients achieved weight loss or maintained their weight. 12% of patients (n = 20) were successful in losing 5 kg body weight, 38% of patients (n = 63) lost up to 5 kg or stayed the same, 13% of patients (n = 22) gained weight and 19% of patients (n = 31) failed to return after the first appointment. Most patients achieved some dietary changes suggested although there was discrepancy between reported change by patients which would have been expected to lead to weight change and actual weight change recorded at the end of treatment. The service offered by the Leicestershire Nutrition & Dietetic Department was generally well received by patients.
Conclusions: Further review of methods of managing obese patients within the time constraints of community clinics is needed, including monitoring and long-term support, and the reliable recording of dietary change.