BMJ: Group programmes for weight loss are more effective than one to one sessions

Adapted from BMJ 26 Feb 2022 NIHR Alert

Around one in four UK adults is living with obesity. Previous research has established that the most effective way to lose weight is through behaviour change with diet and physical activity counselling. It has not been clear whether one to one sessions or group sessions produce the better outcome. Thus a review of 7 studies which included 2,576 participants from the UK, US, Australia, Germany and Spain was done.

The study looked at the outcome of reaching at least a 5% reduction in body weight after a year. This means that a person of 100kg would lose 5kg.

Compared to one to one sessions, people in group sessions:

Lost on average 1.9kg more weight

Were 58% more likely to lose at least 5% of their body weight

Group classes had 12-55 hours treatment time and those in one to one sessions had 2.5 to 11 hours.

The costs of treating people in groups is also lower than one to one sessions. The quality of life of people who are obese would be more likely to improve and their would be fewer cases of diabetes, heart disease, stroke, and cancer that all require medical treatment.

NICE are intending to publish revised guidelines on the treatment of obesity in 2023.

Healthcare professionals can now confidently say that group educational programmes are at least if not more effective than one to one sessions when referring or advising patients. Social support in groups and more intensive interventions may account for greater success but for some people eg who are anxious in groups or who need translators, or even just patient preference, will mean that one to one sessions will still need to be offered. Further research into what specific factors improve results would be helpful.