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'Over-delivered'? Say well done ­ don't bash us

Dr David Haslam points to the success of the Counterweight project, in

which 'up to 40 per cent of patients achieved weight loss after a year' (News, March 5).

Looking at the latest data analysis on the project's website, 282 patients have now completed the one-year programme. The average BMI of the patients in the programme was 37.34 per cent of those completing maintained 5 per cent weight loss.

The intervention is run by practice nurses, and each patient needs about two-and-a-half hours of appointment time to complete the programme.

Looking at my own list, my 430 most obese patients (5.5 per cent of my list of 12,000) have an average BMI of 37. On average these patients are 38kg overweight.

On completing the programme, I could expect that 146 of them would have lost an average of about 2kg each, reducing their average BMI from 37 to 35. Implementing the programme would require a practice nurse working 20 hours a week.

What the Counterweight project has so far demonstrated is that:

·for the most obese 5.5 per cent of patients, whose average BMI is 37, who are, on average, 38kg overweight, one-third will have lost, on average, 2kg after one year

·to achieve these results will require seven-and-a-half hours of practice nurse time per successful patient (as two-thirds of the patients are not successful), or about four hours per kg lost!

It is not yet known whether any of the weight loss is sustained after the end of the programme.

Dr Haslam describes this programme as a 'success'!

Dr Patrick Bower

London SW17

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