It is well established that the period following pregnancy and childbirth is a time when women are likely to gain weight. This has significant consequences for further pregnancies as obese women have a higher risk of impaired glucose tolerance and gestational diabetes, miscarriage, pre-eclampsia, thromboembolism and maternal death( 1 ).
Suitable women (n=547) who presented with a BMI above 30 at antenatal booking clinics in the NHS Tayside (Scotland) region were offered access to a commercial, community-based lifestyle weight management programme (Weight Watchers®) in the postnatal period. Participants received vouchers to attend 12 weekly community meetings, combined with access to online and mobile tools. Data was collected by group leaders and relayed to a central database (weight measured in meetings on calibrated scales). Analysis was based on 87 referrals that commenced between April and June 2012 and completion was defined as attendance at 9 or more meetings (⩾75% engagement). Intention-to-Treat analysis, Baseline Observation Carried Forward (ITT BOCF) was carried out where those attending 8 or fewer sessions were assumed to have maintained their baseline weight (weight change=0).
At baseline participants had a median age of 32 years (Inter Quartile Range 29.1–36.7) with a median BMI of 34.4 kg/m2 (Inter Quartile Range 31.9–39.1). Participants lost an average of 4.84 (SD 4.49) kg, equating to 5.10 (SD 4.79) % of their initial body weight (ITT BOCF). Of the 87 women who were referred 55 (63.2%) completed 9 or more sessions. A higher proportion of older women (32 or above) completed the course (69.8% versus 56.8% respectively) and there was a strong association between the number of meetings attended and weight loss (Pearson correlation coefficient 0.748, P<0.01) and this was reflected in the ITT analysis. Comparison of weight loss in completers showed that older women had a higher mean % body weight loss than younger participants.
* p<0.05 for difference from mean for <32 years using student t-test comparing age groups.
In conclusion, this community-based lifestyle modification programme may be an appropriate intervention for postnatal weight loss in overweight and obese women.
Funded by Weight Watchers (UK) Ltd.
