Official Statistics

Adult tier 2 weight management services: short statistical commentary July 2022

Updated 17 November 2022

Applies to England

Adult tier 2 weight management services provisional data for quarter 1 to quarter 4 of the 2021 to 2022 financial year (experimental statistics): short statistical commentary July 2022

1. Introduction

In March 2021, the government announced an additional £100 million of funding over the 2021 to 2022 financial year to support people living with excess weight and obesity to lose weight and maintain healthier lifestyles.

The adult weight management services grant (number 31/5440) distributed £30.5 million of this new funding between all local authorities in England who accepted the grant, to support the expansion of adult tier 2 behavioural weight management services commissioned by local authorities. This is part of a place-based whole systems approach to tackling obesity and promoting a healthier weight.

In order to understand the impact of this investment, any local authority in receipt of this grant funding must ensure all commissioned service providers collect data on all participants and their progress and return a minimum data set to the Office for Health Improvement and Disparities (OHID).

This publication provides figures for quarter 4 and updated figures for quarter 1 to quarter 3 which supersede the previous publication. Published figures will be updated as new data is submitted retrospectively. Additional quarters of data will be published for those local authorities and providers who have agreed extensions to service delivery until latest 31 December 2022.

2. Interpreting the data

This report includes data for quarter 1 to quarter 4 of the 2021 to 2022 financial year which was submitted by 10 June 2022. Some services were still being set up during this period and we expect further data to be retrospectively submitted for these time periods. Therefore, all counts of people being referred, enrolled and completing services in this report are provisional and are lower than the final figures which will be available when all data for 2021 to 2022 has been submitted. In some instances, no data is available for a local authority as some service providers have not yet submitted data. 145 of the 152 local authorities accepted the grant funding. This report includes data for 127 of these local authorities.

In addition, some data has been submitted for services funded by the existing public health grant or where the funding stream is unknown. Therefore, the findings in this report are not restricted to services funded by the new grant (number 31/5440). This statistical commentary focuses on data from all funding sources. Table 1 in the published data shows the counts of participants by funding stream.

All tables have been updated since the last publication to include figures from January to March 2022 (quarter 4). Quarters 1 to 3 have also been updated for any data submitted following the previous publication. Figures have not yet been added to represent the number of participants followed up in each quarter at 26 weeks following the start of their interventions as numbers are too small to show reliable results. This data will be available in future publications.

In addition, new tables has been added that show participant completion rates by local authority and estimates of participants’ average weight change following their service (tables 18 and 19 respectively).

3. Main findings

For data submitted up to 10 June 2022 covering quarters 1 to 4 of 2021 to 2022:

• 74,935 participants were referred to adult tier 2 weight management services

• 43,755 of these participants enrolled on adult tier 2 weight management services which is an enrolment rate of 58%. 46% of those enrolled were from high-risk groups (see below for definition).

• 9,585 participants had attended at least 75% of the service and were considered to have completed their programme with a calculated completion rate of 38% ^{[footnote 1] [footnote 2]}

• of those 74,935 participants referred to services, 47% of those referred were self-referrals, and a further 31% were GP referrals. The remainder were either referrals from other health care professionals (6%), non-health professionals (4%) or the referral source was unknown (12%) (table 2)

• of those 43,755 participants enrolled on services, 72% were funded by the weight management services grant 2021 to 2022 (No. 31/5440). 20% of participants were funded by existing public health grant funding and 8% were of unknown funding (table 1)

• 65% of participants were enrolled on services with a face-to-face element of its delivery. 48% of participants were enrolled on services delivered at least in part remotely via email, social media, telephone text or video call. 18% of participants were on digital services delivered by technology such as apps and websites (table 3)

• 28% of all enrolments to adult tier 2 weight management services lived in the most deprived 20% of areas in England (table 7)

• 26% of those enrolled were in the obesity III BMI category (≥40 kg/m²), 25% in obesity II (35 to <40 kg/m²) and 35% in obesity I (30 to <35 kg/m²). A further 13% of participants were overweight (25 to <30 kg/m²) and 1% were a healthy weight (18.5 to <25 kg/m²) (table 15)

• 43% of participants had lost weight by the end of their service, with 17% having lost at least 5% of their initial body weight (table 17) ^{[footnote 3]}

• tables also show counts of participants in adult tier 2 weight management by variables such as demographic characteristics, socioeconomic status, health status, and commissioning local authority

4. Summary figures and outcome measures

A total of 74,935 participants were referred to adult tier 2 weight management services in quarters 1 to 4 of 2021 to 2022 – 43,755 of these participants enrolled on services (table 2) which is an enrolment rate of 58% (AWM1, table 17). When broken down by quarters 1 to 4, referrals and enrolments have increased with each quarter throughout the year, with 2,605 participants referred and 1,945 enrolled in quarter one through to 41,975 referred and 21,340 enrolled in quarter 4.

Thirty-eight per cent of participants enrolled on adult weight management services completed the active intervention in quarters 1 to 4 (AWM2, table 17) – this is defined as attending at least 75% of their intervention. This analysis includes participants who have had referral, enrolment and end of service data submitted. It also includes only those participants for whom only referral and enrolment data has been submitted and should have finished their service by the end of quarter 4 but their end of service data has not been submitted. These participants are considered to have not completed their service. ^{[footnote 1]}

Forty-three per cent of all participants enrolled on adult weight management services in quarter 1 and quarter 3 lost weight at the end of their active intervention when compared to their weight at the beginning of the service (AWM4). Furthermore, 17% of participants enrolled on services lost a minimum of 5% of their body weight at the end of the active intervention in quarter 1 and quarter 3 (AWM5).

This analysis (AWM4 and AWM5) is restricted to those participants where both a weight measurement at enrolment and at least one other subsequent weight measurement during their service are available. Those participants where only one weight measurement at enrolment is available are excluded from this analysis as it is unknown whether these participants subsequently lost weight or not.

4.1 Enrolments from high risk groups

High risk groups are defined as:

• person lives in the most deprived 20% of areas in England

• person’s ethnicity is black, Asian or minority ethnic group

• person has a mental illness

• person has a disability (including learning disability)

Forty-six per cent of participants enrolled on services of all enrolments in quarter 1 to 4 of 2021 to 2022 were from high risk groups (AWM3).

Sixteen per cent of all enrolments in quarter 1 to 4 were from ethnic minority groups, with 73% white British and 11% of unknown ethnicity (table 5). Twenty-eight per cent (12,070) of all enrolments in the same period were people living in the most deprived 20% of areas in England (table 7).

Thirteen per cent of participants who enrolled on services in quarters 1 to 4 stated at least one disability, with 59% stating they had no disability and a further 28% of enrolled participants for whom their disability status is unknown (table 11). One per cent of all enrolments were on the Severe Mental Illness register in this period (table 11).

4.2 Type of service

Of those referred to services, 47% of those referred were self-referrals, and a further 31% were GP referrals. The remainder were either referrals from other health care professionals (6%), non-health professionals (4%) or the referral source was unknown (12%).

Sixty-five per cent of participants were enrolled on services with a face-to-face element of its delivery, 12% were individual 1:1 sessions and 53% utilised group sessions. Forty-eight per cent of participants were enrolled on services delivered at least in part remotely via technology, such as email, social media, telephone, text or video call. The majority of these remote services were conducted individually (31% of participants) rather than in groups (17%). Eighteen per cent of participants were on services delivered by using digital technology such as apps, websites, and devices monitoring participants’ physical activity (table 3). These numbers do not sum to 100% as 2 modes could be reported for each participant.

Of those enrolled on services, 72% were funded by the weight management services grant 2021 to 2022 (No. 31/5440). Twenty per cent of participants were funded by existing public health grant funding and 8% were of unknown funding (table 1).

4.3 Weight change following active intervention

Twenty-six per cent of those who enrolled on services in quarters 1 to 4 were in the obesity III BMI category (≥40 kg/m²), 25% in obesity II (35 to <40 kg/m²) and 35% in obesity I (30 to <35 kg/m²). A further 13% of participants were overweight (25 to <30 kg/m²) and 1% were a healthy weight (18.5 to <25 kg/m²) (table 15).

Of the 43,755 that enrolled on services in quarters 1 to 4, 24,800 have had adequate time to complete their programme and have their data submitted.

It is difficult to calculate the average weight loss amongst participants whilst data continues to be collected. For example, some of the 24,800 participants have only had one weight measurement at referral submitted and no subsequent weight measurements even though they should have completed their service by the end of quarter 4.

Therefore, this section provides two estimates of average weight loss (table 19). Firstly, those participants who only had one initial weight measurement submitted are included and it is assumed they had no weight change at all during their service. Secondly, these participants with only one measurement are excluded from the analysis. For both estimates, any participants who were pregnant during the programme are excluded.

The mean weight loss was 2.24kg (95% confidence intervals 2.33-2.16kg), when making an assumption that those participants without an end of intervention weight measurement had no weight change during their service.

When limiting this analysis to only those who have had both a weight measurement at enrolment and at least one other subsequent weight measurement during their service (16,165 participants), the mean weight loss was 3.44kg (95% confidence intervals 3.57-3.31kg).

4.4 Other tables

Data tables have been produced to show counts of participants in adult tier 2 weight management services in England split by age, gender, ethnic group, sexual orientation, religion, local authority and region, employment status, and Index of Multiple Deprivation decile of residence. Tables are also included that show counts of participants by stated disabilities and co-morbidities as well as the type of weight management intervention. These variables have been included in the data collection to further help assess access to services from high risk groups.

The data tables cover the period from April to June 2021 (quarter 1); July to September 2021 (quarter 2); October to December 2021 (quarter 3); and January to March 2022 (quarter 4). Additional quarters of data will be published routinely, and previously published data will be updated as new data is retrospectively submitted.

Figures for outcome measures are calculated where a sufficient amount of data is available. More analysis will be added to subsequent publications as more data is collected. Information will be included in later publications on maintenance of weight loss when the service has finished, informing the ‘Percentage of participants who maintain their lower weight’ outcome measure (AWM6, table 17). This will be available for different population groups and weight management intervention types.

At this stage the data is provisional and published as experimental statistics. OHID are seeking feedback on the data tables from users and stakeholders to improve the quality and useability of the data. We welcome any feedback via [email protected].

5. Background

Further information about this publication and the data used is available as set out below.

Guidance on the data collection is available in the minimum data set technical guidance document.

Detailed metadata for this statistical release is available in the name of spreadsheet.

Further information on the adult tier 2 weight management services grant for local authorities is available in this OHID guidance.

For more information on experimental statistics see the Office for National Statistics Guide to Experimental Statistics.

Responsible statisticians, product leads: Caroline Hancock, Rory Bott

For queries or comments relating to this document and accompanying data tables, please contact: [email protected]

1. Completion rate cannot be calculated by dividing the number of completers by the number of enrolments, as those starting their service in the latest quarter will not have had time to complete their service yet. ↩ ↩²

2. To calculate the completion rate, the analysis includes participants who have had referral, enrolment and end of service data submitted. It also includes those participants for whom only referral and enrolment data has been submitted and should have finished their service by the end of quarter 4 but their end of service data has not been submitted. These participants without end of service data is considered to have not completed their service. ↩

3. This analysis is restricted to those participants where both a weight measurement at enrolment and at least one other subsequent weight measurement during their service are available. Those participants where only one weight measurement at enrolment is available are excluded from this analysis as it is unknown whether these participants subsequently lost weight or not. ↩