An audit of dietary treatment modalities and weight loss outcomes in a specialist obesity clinic

Background: Obesity resistant to conventional treatment is often treated in specialist obesity clinics. Very little is known about treatment outcome or best management in this sector of the obese population and there appears to be a deficit of published audits from specialist obesity clinics. Method: Our clinic population was characterized in terms of BMI, gender, ethnicity and age as well as previous weight loss attempts, referral source and reasons for referral. The treatment modality was noted and outcome measured in terms of weight change; losses of 5% or more from presenting body weight were defined as weight loss. Results: It was found that 33% of the attending clinic population (n=166) lost weight during their treatment phase, although no data was available on the long term maintenance of this loss. Forty-three per cent lost 0-4% of their body weight, while 25% gained weight during their treatment phase. In the group that gained weight a greater number of patients (24%) reported depressive symptoms and required psychiatric or psychological intervention and/or antidepressive medication compared to only 4% of those patients who had lost weight. The most frequently used dietary modality was the low-fat diet, however, all of the treatment methods resulted in weight loss in some patients but not in others. Of particular interest were those patients who tried a number of different treatment methods before finding one which resulted in weight loss. Conclusion: This audit confirms that different treatment methods suit different individuals and highlights the importance of tailoring dietary advice to the individual patient.