Impact case study database

University of Aberdeen research has created a new evidence base to help people with obesity in the UK and internationally. Specifically, it has (i) informed health guidelines for WMPs for adults with obesity in the UK, India, the United States and New Zealand; and (ii) underpinned the development of a successful weight management programme in the UK.

(i) Informing health guidelines for the management of obesity-related illnesses

In the UK

The first systematic review [ R1] provided four meta-analyses used by NICE since 2006 to inform guidance on weight management for adults with low-fat and 600kcal/d deficit diets [ S1 p541], adding behavioural interventions to diets [ S1, p562-4], adding physical activity to diets [ S1, p580-3], and the weight loss drug orlistat [ S1, p618-9]. NICE evidence was only partially updated in 2014, such that current 2014 NICE guidance on the above topics continues to utilise this evidence from 2006 given in Appendix M of its 2014 publication [ S1].

University of Aberdeen research on WMPs for men created an evidence base which has been used by the Men’s Health Forum and Public Health England, in their joint guidance document, ‘How to make weight-loss services work for men’ [ S2i-ii]. Aimed at people developing WMPs, this ‘How to Guide’ summarises the Aberdeen-led research, so that programme developers are made aware what works and what doesn’t. Martin Tod from the Men’s Health Forum has confirmed that the guide has been used in designing weight management services [ S3]. This was the first published guideline on weight management for men with obesity, nationally and internationally.

In India

Evidence from the first systematic review [ R1] was used in the 2015 Indian clinical practice recommendations on management of Type 2 diabetes, as evidence supporting behavioural support for lifestyle change for obesity [ S4i, pS17], stating ‘ Other important components of behavioural therapy embrace self-monitoring, goal setting and stimulus or cue control. Such strategies help in setting up realistic goals, guide patients in identifying stimulus that leads to excessive nutrient intake and eliminate them accordingly’. The same guidance citing R1 was repeated in subsequent Indian diabetes’ clinical practice recommendation updates, including in 2020 [ S4ii].

In the United States

The November 2013 American Heart Association/ American College of Cardiology/ Obesity Society Guideline for the Management of Overweight and Obesity in Adults utilises the first systematic review and all six associated publications from that systematic review for its guidance [ R1, references 36-40 and 54-55 in 2013 AHA report]. Guidance quotes benefits of weight loss, with or without orlistat, on fasting glucose, HbA1c, triglycerides, LDL cholesterol, blood pressure, prevention of Type 2 diabetes and reduction of premature mortality [ S5].

The 2019 update of the US clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures clinical practice guidelines references the University of Aberdeen team’s 2018 research [ R3] for decisions on types of surgery. The research provides the cost-effectiveness evidence in support of Roux-en-Y gastric bypass surgery compared to non-surgical weight management. [ S6, pO27-O28].

In New Zealand

The University of Aberdeen-led research has provided evidence to support national guidelines for adult WMPs in New Zealand in 2017. The evidence section on weight loss interventions for men with obesity relies on the team’s research:

‘A systematic review of evidence-based management strategies for obese men found that men preferred more factual information on how to lose weight and more emphasis on physical activity programmes than women did. They also preferred interventions delivered in social settings to those delivered in health-care settings (Robertson et al 2014 [ R2] *, Robertson et al 2016). Robertson et al concluded that weight reduction for men is best achieved and maintained with the combination of a reducing diet, physical activity advice or a physical activity programme, and behaviour change techniques.*’ [ S7, p11]

The document provides clinical guidance for health practitioners and others who provide advice on weight management for New Zealand adults, where 1-in-3 New Zealand adults is obese.

(ii) Underpinning the development of a successful weight management programme for men

In the UK, the University of Aberdeen-led systematic review [ R2] and resulting guidance from Public Health England and the Men’s Health Forum [ S2i] has informed the development of the MAN V FAT weight management programme (https://manvfat.com/about\-man\-v\-fat/\). MAN V FAT was founded by Andrew Shanahan, specifically for men in 2014, with a crowdfunding campaign aimed at launching a digital magazine about men’s weight and how to lose weight. The campaign attracted support from Jamie Oliver, the National Obesity Forum, Weight Concern and the British Dietetic Association, and was so successful that, along with the magazine, Shanahan also created a website and published a book to help men lose weight. In 2016, Shanahan launched MAN V FAT Football, which now has over 90 football leagues across the UK, all of which are Football Association affiliated, and a further 12 leagues – MAN V FAT Soccer – in Australia. Shanahan wrote in a 2015 media article that ‘ the really great thing about Avenell’s research is that it has galvanised weight management teams across the country…Man V Fat began to work with … Public Health England guidance to create a best practice weight management programme’ [ S8].

The value of the research is further confirmed in correspondence with Andrew Shanahan, where he stated that ‘ the principles of MAN v FAT Football are underpinned by the research, which found that provision of suitable programmes was previously lacking’ [ S9]. MAN v FAT Football is also accessible for free at a number of leagues in the UK due to localised public health funding. These include leagues in Westminster, Kensington, Strood, Lincoln, Boston, Hastings, Skegness, Eastbourne, Falmer, Basingstoke, Eastleigh, Andover and Aldershot. Collectively, the leagues have to date helped around 20,000 men lose weight and gain fitness. Over 90% of men lose weight on completion of their first season, with over 271,000lb lost to date.