Tuesday 12 May 2009 2:03pm
For people trying to maintain weight after participation in a weight-loss programme, support from nurses is as effective as a more expensive intensive programme with dieticians and exercise specialists. The finding is from a study by University of Otago researchers, and is published in Canadian Medical Association Journal.
The study, a randomised controlled trial with 200 women aged 25-70 years old, included women who had lost five per cent or more of their body weight. Most participants were followed for two years after the initial weight loss.
In addition to nutritional counselling and materials provided to all participants, the people in the Nurse Support Programme received 5-10 minute weigh-in visits with a nurse every two weeks for two years. On alternate weeks, they received a phone call from the same nurse to discuss progress. The intensive support programme was based on the Finnish Diabetes Prevention Study.
It appears that regular face-to-face interaction with a supportive health professional is a key success factor, says Professor Jim Mann from the Edgar National Centre for Diabetes Research, University of Otago.
"Although this and other intensive programmes have been successful, the costs to implement these programmes are considerable and well beyond the means of health budgets in many countries."
While attendance at weigh-ins was excellent, attendance at exercise classes in the intensive programmes was poor and declined dramatically in the second year.
"Many participants reported that the weigh-ins and the enthusiastic support provided by the nurse on those occasions and on the telephone were key determinants of their success," says Professor Mann.
The authors conclude that nurse-led programs with weekly or bi-weekly weigh-ins could be easily introduced in many countries where general practice is the cornerstone of the health care system at a fraction of the cost of intensive-support programs.
In a related commentary Dr Robert Ross from Queen's University in Kingston, Ontario writes that "how and how often support is provided may be more important that who provides it" as the nurse in the study had little training in nutrition and exercise but was supportive and enthusiastic.
Dr Ross notes that introducing nurse-coordinated programmes in countries like Canada, where there is a shortage of nurses, may not be feasible. Exercise specialists and dieticians with relevant training can provide similar support for people wanting to maintain weight loss. He credits the study for demonstrating that clinically meaningful weight loss can be maintained over an extended period of time.
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Note: Please credit CMAJ, not the Canadian Medical Association. CMAJ is an independent medical journal.
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