Tier 3 Weight Groups

South West PeninsulaGeneric Health Relevance
Start Date: 22 Jan 2016 End Date: 30 Nov 2017

The design, evaluation and implementation of a group-based programme for weight management in Tier 3 obesity care


The research question came from a question submitted to our question prioritisation in December 2015 and our stakeholders voted it a key research priority. The project team were brought together for their first meeting in January 2016.

Tier 3 obesity care is for obese individuals (usually with a body mass index ≥35 with comorbidities or 40+ with or without co-morbidities) who have not responded to previous interventions. A tier 3 service is comprised of a multi-disciplinary team of specialists, led by a clinician and typically including amongst others: a physician (consultant or GP with a special interest); specialist nurse; specialist dietitian; psychologist or psychiatrist; and physiotherapist/physical activity specialist/physiology.

There is widespread variability in availability, and the format of delivery, of tier 3 services for weight-management throughout the UK. Increasing demands on obesity services are leading to a range of formats of group interventions being introduced; sometimes based on theoretical underpinnings and sometimes as a pragmatic measure to cope with the demand for services.

There are well recognized benefits and challenges to implementing group sessions in individuals referred for weight management support: economic gains, peer support, role models, dominance of the groups by individuals with more severe psychological issues.

Project aims and objectives

  • To identify how groups are currently used to deliver tier 3 obesity services.
  • To work with stakeholders to share knowledge across the region.
  • To use current knowledge to propose the optimal format for group session delivery
  • To evaluate the proposed optimal format delivery
  • To propose suitable evaluative tools in addition to those already used.

Project activity

Our initial approach has been to determine the current situation in the provision of group work in the services.  We have collaborated with the Association for the Study of Obesity (ASO) members across the country and local providers in the region to ascertain variation in service delivery.

Anticipated outputs

We are analyzing and concluding this scoping work now, from which we intend to publish a paper of our findings, and then further develop this working into a funding bid for an intervention study.

Next steps

There are several stages planned for the project, initially we want to review the current research in the area, meeting with patients and the public to get their perspectives. Then work with external partners to develop a funding application.

Dr Dawn Swancutt