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

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.

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.

Public healthcare facility providing primary healthcare services in Cape Town, South Africa.

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. Socio-demographic variables, blood pressure, smoking status, weight, height, waist circumference, dietary intake, physical activity and stage of change were measured.

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).

The group-based intervention was more effective than usual care in weight reduction as well as improvements in physical activity and stage of change.