A brief GP intervention for weight loss: The BWeL-B feasibility trial

INTERVENTION: After GPs have dealt with the participating patient’s original presenting complaint(s), and have confirmed the appropriateness of proceeding, they will briefly deliver one of two treatments, which the participant is randomly allocated to. The treatments include: A referral to a commercial weight management service (CWMS) stating the cost (basic cost), and referral to a CWMS stating the cost compared to the weekly cost of an item that people commonly buy but could choose not to (cost‐comparison). Consistent with the assistance orientated treatment arm of the BWeL trial, the GPs brief intervention is aimed to last no more than a few seconds. For example, in the ‘basic cost’ arm: “Did you know that the best way to lose weight is to go to Slimming World or Weight Watchers? It costs about £5/6 per week but can really boost your weight loss. We can book an appointment today if you would be willing to give it a go.” The cost‐comparison arm will have a relatively minor difference: “Did you know that the best way to lose weight is to go to Slimming World or Weight Watchers? It costs about the same as two cups of coffee a week but can really boost your weight loss. We can book an appointment today if you would be willing to give it a go” The choice of weight management service will mainly be determined by availability in the local area. If the person agrees to referral to the CWMS, the GP will ask the participant to make an appointment at reception and to return in a month: “I know it can be difficult to lose weight, so I’d like you to return in a month to see how you are getting on”. If the participant wants to try weight loss without assistance, the GP might say: “It's fine for you to try to lose weight on your own but I know it’s hard. Would you like to make an appointment to return in a month to see how you are getting on?” This provides an opportunity to re‐refer those who accepted referral but did not attend, refer those who tried to lose weight on their own but di CONDITION: Obesity ; Nutritional, Metabolic, Endocrine ; Obesity PRIMARY OUTCOME: Attendance at weight management programme assessed using participant report via telephone at 3 weeks after the consultation. INCLUSION CRITERIA: 1. Body mass index (BMI) >30 kg/m2 (or >25 kg/m2 for South Asian population groups) and excess body fat 2. Aged 18 years or over 3. Participant is willing and able to give informed consent for participation in the study and comply with study procedures. SECONDARY OUTCOME: 1. Acceptance of GP referral immediately after the appointment, specifically whether they planned to attend the weight management programme in the immediate future (recorded immediately after the referral by the investigator). ; 2. Participants also rate the helpfulness and the appropriateness of the GP’s very brief intervention on five‐item Likert‐type scales.; 3. Participants’ thoughts about the opportunistic intervention, (and the script specifically) that was delivered when they visited for reasons other than their weight. Also whether other styles may have resulted in a different reaction than the one experienced. This is assessed using a 3‐week follow‐up phone call via a semi‐structured interview by the investigator. ; 4. GPs' thoughts and attitudes about the two brief intervention scripts. This will include exploring: why GPs felt as they did; whether other brief interventions might be more or less acceptable than the one they gave; and whether these interventions might be suitable for all people who are obese, or only those with relevant medical conditions. This is measured via a questionnaire pre‐ and post‐intervention and a semi‐structured interview up to 1 week post‐intervention. ; 5. Comparison of the proportion of participants who attend a weight management programme in each treatment arm (basic cost vs cost comparison) at 3‐week post‐intervention follow‐up.; ; ;