An integrated approach is needed to achieve durable weight loss and improvements in metabolic health, that is not only anthropometric-centric but also as a chronic disease complication-centric. The last 18 months with the COVID-19 pandemic has challenged care provision and the ability to optimise weight management for society overall. The literature indicates a consistent finding of adverse outcomes with COVID-19 in individuals with the metabolic syndrome.
Aim: To evaluate the results of patients receiving individualised multidisciplinary care from specialists in endocrinology, dietetics, exercise physiology, and surgery at the Healthy Weight Clinic (HWC).
Methods: A retrospective chart review was conducted to identify patients who attended an initial consultation at HWC between March 2017–March 2019 and followed up through the pandemic thus far. Changes in weight, BMI, waist circumference, percentage weight loss, and body composition outcomes and obesity related complications were evaluated. Analysis during the 2020 lockdown was also performed.
Results: 199 of the total 239 patients followed up at the HWC and were treated by the multi-specialist team (83.3% reattendance rate). Average baseline weight was 106.9kg(21.2kg SD) and BMI 37.9kg/m2(7.1 SD). Of patients who reattended the clinic the mean final weight change was -9.0kg(11.1 SD) equating to -7.9% mean body weight change. With multidisciplinary support patients maintained weight loss during the pandemic or with re-engagement with clinical care were able to re-achieve weight loss. 38.4% of patients who returned reduced their BMI class by at least one class and improved their obesity related comorbidities, improving their stage of obesity.
Conclusion: Multi-specialist holistic care provides clinically significant weight loss with better outcomes in the patients regularly following up with the team both in the medical and surgical sub-cohorts, especially during the COVID-19 pandemic. Our results also demonstrate that there is an improvement in metabolic co-morbidities with holistic care.