A Remotely Delivered Weight Management Service to Support Existing Obesity Services in the UK National Health Service: Preliminary Findings From an Early-Stage Service Evaluation.

Background: Specialist weight management services (SWMSs) in the UK National Health Service (NHS) face long waiting lists and limited resources. Remotely delivered SWMSs may support existing NHS services to increase access to treatment for patients living with obesity; however, evidence of remotely delivered services working to support NHS SWMSs in practice remains limited. Objective: This study aims to explore the potential effectiveness, feasibility, and acceptability of Second Nature's remotely delivered SWMS for adults living with obesity referred from existing NHS SWMSs. Preliminary findings from the first phase (Preparing for weight loss) of a 3-phase remotely delivered SWMS are presented. Methods: A total of 39 adults (age range 23-74 years, mean age 45.6, SD 12.1; 74% female) completed a 16-week intervention, following referral from NHS SWMS leads. Eligible participants were assessed by a multidisciplinary team and allocated to one of three interventions: (1) a psychologically informed app-based intervention, (2) a Dialectical Behavioral Therapy (DBT)-based skills training group intervention, and (3) one-to-one psychological support. The primary outcomes were weight change (kg) and percentage weight change following completion of the intervention. Secondary outcomes included psychological distress, emotional eating, health-related quality of life, physical activity, emotion regulation, intervention feasibility, and acceptability. Results: At 16 weeks, the mean weight change was -2.2 kg (SD 5.16), or -1.6% of body weight. Participants in the app-based intervention lost the most weight (-2.8kg), and participants in the one-to-one psychological support intervention lost the least weight (-1.3kg). Psychological distress was reduced to below the clinical threshold (mean score 0.95, SD 0.62). Emotional eating behaviors and difficulties in emotion regulation also decreased (mean change scores -3.2, SD 6.4 and mean -11.6, SD 13.9, respectively). Health-related quality of life saw improvements in self-care, usual activities, and anxiety and depression, while participants' challenges with mobility, and pain and discomfort remained unaffected. Subjective ratings of health status improved by 17.4%. There were no significant changes in physical activity levels, with most participants remaining "Inactive" or "Moderately inactive." Engagement with intervention sessions was high (93.7%) and the attrition rate was 27.4%. Participants rated their satisfaction with the intervention at 9/10 and highlighted key benefits, including improved mental well-being, healthier habits, and supportive coach relationships. Suggested improvements included greater scheduling flexibility, enhanced app functionality, and more accessible physical activity support. Conclusions: This preliminary service evaluation suggests that a remotely delivered SWMS has the potential to be effective, feasible, and acceptable for NHS-referred patients in the United Kingdom. Changes observed across several key measures point to clinically significant benefits, reinforcing the potential of this approach. A full evaluation of all 3 phases of this service with a larger sample size is required to support these early findings.