Weight Management Service ProtocolMay 2007

Criteria for inclusion; BMI>30kg/m2 or

BMI>25kg/m2 plus co-morbidity (eg Type 2 diabetes, hypertension or high total cholesterol)

Age 18 – 75years

Session / Measurements / Topic / Resources
GP or dietitian appointment /
  • Raising the issue of being overweight
  • Referral to weight management service.
/
  • Referral criteria
  • List of pharmacies for referral
  • Referral form

Self referred / See Guidelines for self referral
First contact (10 minutes with patient + 5 minutes administration time) /
  • Explain scheme
  • Complete patient record sheet
  • If patient is eligible give a brief explanation of the paperwork and personal nature of the questions and arrange next appointment
  • If ineligible, Arrange referral to dietician (if this route is available) or return to GP care
/
  • Patient record sheet
  • Patient Guide to Weight Management scheme
  • 3 day food diary
  • Motivational questionnaire
  • Quality of Life Questionnaire
  • Data monitoring form
  • Adviser’s guide to Weight Management Scheme

Week 1
(30 minutes with 1:1 adviser + 15 minutes administration time)
Emphasis on assessing motivation and dietary changes / Weight measurement
BMI
Waist Circumference
BP /
  • Risks of being overweight
  • Benefits of 10% weight loss
  • Programme details
  • Assess motivation
  • Healthy eating information
/
  • Weight management record card
  • Dietitian referral information
  • Patient monitoring sheet
  • Patient goals and notes
  • ‘Eat smart Shop smart Cook smart’ information

Week 2
(30 minutes with 1:1 adviser + 15 minutes administration time)
Emphasis on changes in activity and continue with information on healthy eating. / Weight measurement /
  • Commitment to programme- contract
  • Referral to dietician programme
  • Signpost to exercise referral programme and health promotion
  • Food and activity diary
  • agree realistic weight reduction goals
/
  • Contract
  • Exercise referral and health promotion details
  • Pedometer
  • BHF leaflet ‘So you want to lose weight for good’
  • Range of leaflets for advisers to use as they see appropriate

Week 3
(15+5 minutes with 1:1 adviser) / Weight measurement /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
30 minute dietitian appointment at week 4
Week 4
(15+5 minutes with 1:1 adviser) / Weight measurement /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
Week 6
(15+5 minutes with 1:1 adviser) / Weight measurement /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
  • Discuss supply of Orlistat if appropriate
/ Orlistat information
Week 8
(15 minutes with pharmacist if Orlistat recommended and supply
if appropriate) and (15+5 minutes with 1:1 adviser)
NB BMI ≥28 with co morbidities, or BMI ≥30 / Weight measurement
BMI
Waist circumference
BP /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
  • Orlistat supply if appropriate
/ Orlistat PGD
Week 10
(15+5 minutes with 1:1 adviser) / Weight measurement /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
  • Orlistat side effects?
/ Orlistat PGD
Dietitian group session, between week 10 to 14
Week 12
(5 minutes with pharmacist if orlistat supply appropriate) and(15+5 minutes with 1:1 adviser) / Weight measurement
BMI
Waist circumference
BP /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
  • Orlistat supply if appropriate
/ Orlistat PGD
Week 14
(15+5 minutes with 1:1 adviser) / Weight measurement /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
Week 16
(5 minutes with pharmacist if Orlistat supply appropriate) and(15+5 minutes with 1:1 adviser) / Weight measurement
BMI
Waist circumference
BP /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
  • Orlistat supply if appropriate
/ Orlistat PGD
Week 20
(5 minutes with pharmacist if Orlistat supply appropriate and(15+5 minutes with 1:1 adviser) / Weight measurement
BMI
Waist circumference
BP /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
  • Orlistat supply if appropriate (should be 5% weight loss since Orlistat started
/ Orlistat PGD
Quality of life questionnaire
Week 24
(5 minutes with pharmacist if orlistat supply appropriate and
(15+5 minutes with 1:1 adviser) / Weight measurement
BMI
Waist Circumference
BP /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
  • Orlistat supply if appropriate
  • Satisfaction survey
  • Record Quality of life scores
  • Discuss maintaining motivation to continue weight loss or weight maintenance
/ Satisfaction survey
Final measurements record
GP letter to recommend future treatment. Offer to return at 9+12 months.
9 Months / Weight measurement
BMI
Waist Circumference
BP /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
  • Orlistat supply if appropriate
  • Satisfaction survey
  • Record Quality of life scores
  • Discuss maintaining motivation to continue weight loss or weight maintenance
/ Satisfaction survey
Final measurements record
GP letter to recommend future treatment. Offer to return at 9+12 months.
12 Months / Weight measurement
BMI
Waist Circumference
BP /
  • Review and reinforce:
-Goals
-Barriers and support
-Activity diaries
  • Orlistat supply if appropriate
  • Satisfaction survey
  • Record Quality of life scores
  • Discuss maintaining motivation to continue weight loss or weight maintenance
/ Satisfaction survey
Final measurements record
GP letter to recommend future treatment. Offer to return at 9+12 months.

Dietitian Sessions

Session 1
(30 minutes 1:1 session with dietician)
Week 4 /
  • Principles of a healthy diet
  • Food groups
  • Top tips
  • Reviewing food diaries
  • Reviewing activity diaries
  • Setting goals
/ Set yourself some goals leaflet
Recipe adaptation leaflet
10 tips for healthy eating
Session 2
(90 minute group session with dietician)
Around week 10 to 14 /
  • Working towards an ideal food balance
  • Portion control
  • Food labels
  • Shopping tips
  • Eating out
/ Portion plate
Reading labels leaflet
Shopping tips leaflet
If you’re thinking of having a takeaway leaflet/eating out leaflet

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