Official Statistics

Adult tier 2 weight management services: short statistical commentary September 2023

Updated 23 November 2023

Applies to England

Introduction

In March 2021, the government announced an additional £100 million of funding over the 2021 to 2022 financial year to support people living with excess weight and obesity to lose weight and maintain healthier lifestyles.

The adult weight management services grant (number 31/5440) distributed £30.5 million of this new funding between all local authorities in England who accepted the grant, to support the expansion of adult tier 2 behavioural weight management services commissioned by local authorities. This is part of a place-based whole systems approach to tackling obesity and promoting a healthier weight.

To understand the impact of this investment, any local authority in receipt of this grant funding must ensure all commissioned service providers collect data on all participants and their progress and return a minimum data set to the Office for Health Improvement and Disparities (OHID).

The data collection has now closed, this publication provides the final figures covering the period April 2021 to December 2022 and supersedes the previous publication.

Interpreting the data

This report includes data for the period April 2021 to December 2022 which was submitted by 22 June 2023 when the data collection closed. In some instances, no data is available for a local authority as some service providers did not submit data. 145 of the 152 local authorities accepted the grant funding. This report includes data for 132 of these local authorities.

In addition, some data has been submitted for services funded by the existing public health grant (27% of service enrolments) or where the funding stream is unknown (7% of enrolments). Therefore, data is not restricted to the 65% of service enrolments funded by the new grant (number 31/5440). Unless otherwise stated, the commentary in this report refers to all data submitted regardless of funding stream. Table 1 in the published data shows the counts of participants by funding stream. The subsequent tables contain data split by funding stream.

The majority of tier 2 weight management services provide 12 week programmes, but there is some variation between services. The OHID minimum dataset collects data at 4 time points:

• referral
• enrolment onto the weight management service (week 0)
• at the end of the active intervention (which is usually at week 12)
• follow up data is collected at week 26 (usually 14 weeks after the end of the active intervention)

Main findings

For data submitted up to 22 June 2023 covering the period April 2021 to December 2022:

• 134,445 people were referred to adult tier 2 weight management services

• 87,320 of these participants enrolled on services which is an enrolment rate of 65%

• 44% of participants enrolled on services were from high-risk groups (table 16):
  • 15% of participants enrolled were from minority ethnic groups (table 5a)
  • 26% of participants enrolled were people living in the most deprived 20% of areas in England (table 6a)
  • 12% of participants who enrolled stated at least one disability (table 10a)
  • 2% of participants enrolled were on the severe mental illness register (table 10a) ^{[footnote 1]}

• 32,065 participants had attended at least 75% of the intervention weeks in the total length of the service and were considered to have completed their programme, a completion rate of 37% ^{[footnote 2]}

• 11,620 participants had follow up data submitted 26 weeks following their enrolment (table 15a) ^{[footnote 3]}

• of those 134,445 people referred to services, 40% were self-referrals, and a further 29% were GP referrals. The remainder were either referrals from other health care professionals (10%), non-health professionals (4%) or the referral source was unknown (17%) (table 2a)

• 66% of participants were enrolled on services with a face-to-face element of its delivery. 59% of participants were enrolled on services delivered at least in part remotely via email, social media, telephone text or video call. 15% of participants received digital services delivered by technology such as apps and websites (table 3a) ^{[footnote 4]}

• 26% of those enrolled were in the obesity 3 body mass index (BMI) category (≥40 kg/m2), 25% in obesity 2 (35 to <40 kg/m2) and 34% in obesity 1 (30 to <35 kg/m2). A further 13% of participants were overweight (25 to <30 kg/m2) and 1% were a healthy weight (18.5 to <25 kg/m2) (table 14a)

• 43% of participants had lost weight by the end of their active intervention, with 16% having lost at least 5% of their initial body weight (table 16) ^{[footnote 5]}

Detailed findings

Weight change following active intervention

Differences in data completeness at each stage of the weight management service makes it difficult to produce reliable estimates of average weight loss among participants. Table 19 provides 3 estimates of average weight loss:

• firstly those participants with only one initial weight measurement submitted were included and it is assumed they had no weight change at all during their service. This gave a mean weight loss of 1.95kg (95% confidence intervals 2.00 to 1.90kg)

• secondly, those participants with only one measurement were excluded from the analysis. This gave a mean weight loss of 3.07kg (95% confidence intervals 3.14 to 3.01kg)

• the final method only includes those participants who attended at least 75% of the programme and are therefore classed as completed. This gave a mean weight loss of 4.06kg (95% confidence intervals 4.16 to 3.97kg)

For all these estimates, any participants who were pregnant during the programme are excluded.

Table 20 shows data on the movement between BMI classifications of enrolled participants between the start and end of the active intervention. 76% of the participants who started the intervention in the ‘obesity 1’ classification (BMI 30 to <35 kg/m2) remained in that classification, 22% moved to the lower ‘overweight’ classification (BMI 25 to <30 kg/m2) and 2% moved to a higher BMI classification. 26% of enrolled participants in the ‘obesity 2’ (BMI 35 to <40 kg/m2) classification moved to the lower ‘obesity 1’ classification. 18% of enrolled participants in the ‘obesity 3’ (BMI ≥40 kg/m2) classification moved to the lower ‘obesity 2’ classification.

Follow up data

Follow up data at week 26 was submitted for 11,620 of the 87,320 (13%) participants who enrolled in a service (table 15a). Of the 52,055 participants with week 12 (or end of active intervention) data 10,640 (20%) had week 26 follow up data submitted. Due to the low level of follow up data submitted caution is required when interpreting any analysis, as the data is not complete and may be a biased subset.

18% of participants who had lost weight at the end of the active intervention had maintained the weight loss at week 26 follow up (AWM6, table 16). This is calculated by dividing the number of people who had week 26 data submitted and showed they have maintained their weight loss, by the total number of people who lost weight at the end of the active intervention. The calculation assumes that participants who didn’t have week 26 follow up data submitted did not maintain the weight loss. Therefore, the data in tables 16, 17a and 17b (outcome measures by gender, age group, ethnic group, deprivation decile, referral source, and BMI classification) should be interpreted with caution as some of those participants with no week 26 data may have maintained their weight loss.

Other tables

Data tables have been produced to show counts of participants split by age, gender, ethnic group, sexual orientation, religion, local authority and region, employment status, and Index of Multiple Deprivation decile of residence. Tables are also included that show counts of participants by stated disabilities and co-morbidities to further help assess access to services from high-risk groups.

Background

Further information about this publication and the data used:

• guidance on the data collection is available in the minimum data set technical guidance document

• detailed metadata for this statistical release is available Adult tier 2 weight management services: data tables September 2023

• further information on the adult tier 2 weight management services grant for local authorities is available in this OHID guidance

• for more information on experimental statistics see the Office for National Statistics Guide to Experimental Statistics

Responsible statisticians, product lead: Caroline Hancock, Catherine Bray

For queries or comments relating to this document and accompanying data tables, contact: PHA-OHID@dhsc.gov.uk

1. High-risk groups are defined as: person lives in the most deprived 20% of areas in England, person’s ethnicity is black, Asian or minority ethnic group, person has a mental illness, person has a disability (including learning disability). ↩

2. Participants without end of service data are considered to have not completed their service; this may include some participants who did complete the service but their data was not submitted before the data collection closed.  ↩

3. To be included in the follow up data, participants must have referral and enrolment (week 0) data submitted. ↩

4. Data on type of intervention may not fully capture the details of service delivery where a service uses more than two delivery modes. Local authorities were asked to report on the main 2 modes of delivery. The delivery modes are set out in the minimum data set technical guidance. ↩

5. This analysis is restricted to those participants where both a weight measurement at enrolment and at least one other subsequent weight measurement during their service are available. Those participants where only one weight measurement at enrolment is available are excluded from this analysis as it is unknown whether these participants subsequently lost weight or not. ↩