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Group-based intervention in a primary healthcare setting was more effective for weight loss than usual care

Kathryn Manning
Marjanne Senekal2 Senekal
Janetta Harbron


Background: Literature and practice recommendations for lifestyle interventions to treat the increasing number of obese patients with non- communicable diseases (NCDs) or risk factors for NCDs attending resource-constrained public healthcare facilities in South Africa are scarce.
Aim: To compare the impact of a facility-based therapeutic group (FBTG) intervention with usual care on weight in obese participants, with NCDs or risk factors for NCDs.
Setting: Public healthcare facility providing primary healthcare services in Cape Town, South Africa.
Methods: A quasi-experimental study design was used where participants chose to receive weight loss treatment with either the FBTG or usual care interventions. Both interventions involved a one-on-one medical and dietetic consultation, while FBTG participants had six additional group  sessions. Follow-up assessments took place 6 months after baseline. Sociodemographic variables, blood pressure, smoking status, weight, height, waist circumference, dietary intake, physical activity and stage of change were measured.
Results: Of the 193 obese adults enrolled, 96 selected the FBTG and 97 selected usual care. There were no significant differences at baseline  between the two groups. Weight loss over 6 months was greater (p < 0.001) in FBTG (median [IQR] of -2.9 [-5.1; -0.3] kg) than usual care (-0.9 [-0.9; 0.6] kg) participants. At 6 months, more FBTG completers reached the weekly target of 150 min (p = 0.009), while both groups showed  improvements in dietary intake. More FBTG (74%) than usual care (49%) participants were in the action stage of change by 6 months (p = 0.010).
Conclusions: The group-based intervention was more effective than usual care in weight reduction as well as improvements in physical activity and stage of change.

Keywords: Group-based intervention; Weight loss; Non-communicable diseases; Primary health care; South Africa.