PROGROUP: ImPROving GROUP treatment for people with severe obesity

Background

Severe obesity reduces life expectancy due to potential development of diabetes, heart disease and cancer. People with severe obesity also report greatly impaired quality of life. One treatment option is weight-loss surgery, but few people choose this, and other treatment options are limited.

The NHS provides specialised weight management services for people with severe obesity, but what these Tier 3 clinics do, and how effective they are is unclear. Our project seeks to better understand these clinics and investigate whether a new facilitator-led, intensive, group-based behavioural programme (PROGROUP) is more effective and less costly than usual care for people with severe obesity.

Aim of the research

The aim is to adopt best practice for group based treatment in Tier 3 weight management and to establish whether PROGROUP is in fact more effective and less costly than NHS usual care.

Design and methods

The Feasibility Trial 

Initially we ran three test groups to establish if PROGROUP would work on a larger scale, following which we randomly allocated recruited patients to the new service if they were willing to be involved in the study. This stage included up to 100 patients at three clinics, receiving weight management services, with or without the new group programme. If this stage was successful, we would move to a large trial in the final stage of the research.  

The Main Trial 

This large-scale study will take place in approximately 8 centres around the UK and involve up to 1,000 patients. As in the feasibility trial, patients will receive either PROGROUP or usual care. This will be decided by a computer. After 12 months we will assess each participant’s weight and determine whether the PROGROUP intervention improves patients’ health. We will also assess whether the intervention is cost-effective for the NHS. 

Patient and public involvement

A patient advisory group and an implementation advisory group was set up, which has been central to developing and setting-up PROGROUP, and in identifying the impacts from the trial that are most relevant to patients. 

These groups met virtually and also provided feedback to the research team on an individual basis. Both groups have been invaluable in providing feedback on the project plans and materials.  

Hear our Patient and Public Involvement (PPI) group member Steve Perry talk about the importance of including a PPI perspective in the study:

Dissemination

Our findings as to delivery of successful services that meet patients’ needs will be shared regionally, nationally and internationally with the help of the patient expert consultation group. We will do this through weight management groups we have worked with and our many stakeholders –including Association for the Study of Obesity, British Dietetic Association, commissioners and NHS England. The results will also be published by press releases, newsletters, social media and in health journals.

Project activity

Working with a national team of specialist service providers, service users, Tier 3 commissioners, dietician, psychological and implementation science experts we have devised a proposal to optimise how the dynamics of how a group-based service for people with severe obesity may be developed and used.

In September 2020 the project was awarded nearly £2.5 million from the National Institute for Health Research (NIHR) and the 5-year research study began on 1st May 2021.  

The feasibility stage of this project concluded in the Autumn of 2023, and the team carried forward the knowledge gained, from data collected and from discussions at the final feasibility trial Stakeholder meeting, consultations with our steering committee, project management group and patient advisory group. Providing insights to inform, improve and refine intervention materials and the training plan for facilitators delivering the intervention, and all participant-facing documents. You can read more about the feasibility trial here: https://theprogroupstudy.co.uk/the-trials/feasibility-trial/ 

Thanks to the efforts of our participating sites and to the willingness of participants to be involved in the feasibility work, we successfully progressed to the main trial. 

Next steps

PROGROUP sites continue to work incredibly hard recruiting patients, running PROGROUP sessions and providing lots of valuable insights.  

During 2024, one of our sites completed the first delivery of the new PROGROUP intervention in full and are moving onto their third. They are also supporting us, giving feedback attending interviews with the researcher team. 

Acknowledgements 

We are grateful for the support from the research Sponsor for this study, University Hospitals Plymouth NHS Trust, and our public and patient advisory group for their input in developing this research. 

We are incredibly grateful to have such fantastic PROGROUP sites across the country, all working incredibly hard on our behalf.  

World Obesity Day, is a unified day of action that calls for a cohesive, cross-sector response to the obesity crisis. Convened by the World Obesity Federation in collaboration with its global members.  

You can read more about it on the World Obesity Organisation website, here: About WOD | World Obesity Day 

The World Obesity Federation have collated a range of really useful technical resources, visit here to access campaign assets and other resources.