Evaluation of a virtual, person-centred physical activity tool kit in an NHS specialist weight management service

Supervisors: Dr David Webb drw17@le.ac.uk  and Professor Tom Yates ty20@le.ac.uk

Project Description:

People living with complex obesity (BMI>35KGm-2) require multidisciplinary expertise to achieve healthier weight. Physical activity is beneficial across a range of long-term conditions including obesity, yet most NHS specialist weight management services do not prioritise movement as a key component of holistic care. Only 20% include a physical activity expert as part of the core “MDT” and less than 50% of service specifications mention physical activity at all.  Lack of evidence of an effect on weight loss per se and the unit cost of typical face-to-face physical activity interventions in this setting may disincentivise commissioning. Online support tools supporting personalised physical activity interventions may improve the effectiveness of this important component of specialist weight management. If of benefit to users they would represent an easily implementable, efficient use of resources. In addition to established benefits independent of weight loss, the role of physical activity in support of weight loss maintenance following other interventions eg. Low energy diet, bariatric surgery and pharmacotherapy needs to be considered as a new emerging role for these services.     

Aim: To design and test online tools to facilitate person centred physical activity interventions in an NHS “Tier 3” specialist weight management service.

Project outline

Year 1: Systematic review of 1) virtual and 2) face to face physical activity interventions as components of multifactorial care packages in people with overweight or obesity. Aim to establish evidence base for proposed intervention in similar settings, including mode of delivery, use of online support tools and outcome measures  

Year 1: Systematic review of physical activity interventions aimed at weight maintenance after 1) discontinuation of medical weight loss pharmacotherapy and 2) following bariatric surgery. Aim to establish evidence base for physical activity as a modality for weight loss maintenance.  

Year 1+2: Adapt and redesign an online resource and physical activity dashboard to meet the specific needs of people under 60 years of age who are motivated to improve their health and well-being through physical activity and are attending the University Hospitals of Leicester specialist weight management service (UHL-SWMS). 

Year 1+2: Ethics, set up, training within sate of the art research facilities, experience of NHS weight management services.

Years 2+3: Pilot the dashboard and intervention tools in the UHL-SWMS assessing uptake, engagement, retention, and linkage with a new physical activity component of the UHL-SWMS. Determine within group effects on physical activity and function, biomedical parameters, and well-being at 1, 3 and 6 months. Compare outcomes in a case-control study with people attending the service but not choosing a physical activity component.

The student will join 15 lifestyle intervention-based researchers and PGR students at the Leicester Diabetes Centre.  will benefit from the impressive infrastructure and expertise within the Lifestyle and Nutrition theme of the NIHR Leicester Biomedical Research Centre based there. David Webb is a senior researcher within this and clinical lead for the UHL-SWMS. He is actively involved in several weight management clinical research studies and is PI for industry led weight loss / diabetes pharmacotherapy phase 3 clinical studies.  Tom Yates has extensive expertise in physical activity based human experimental research and is an implementation lead for Leicester Diabetes Centre. He has published work around physical activity interventions in patients after Bariatric surgery. Louisa Herring an internal collaborator is part of an international collaboration looking at the role of physical activity in this setting. The Leicester Diabetes Centre is one of the largest research centres for metabolic disease in the UK. It employs over 150 staff and students involved in high quality research, teaching and service implementation. The Centre has strong links to the UHL-SWMS and other services, including primary and secondary care-based Diabetes.