{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:04:03Z","timestamp":1779789843647,"version":"3.53.1"},"reference-count":67,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004941","name":"Guy's and St Thomas' NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004941","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp;amp; Metabol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Obesity management in the UK includes multicomponent weight and behavioural interventions delivered at Tier 3 of the NHS model of care. This study presents the impact of and comparative outcomes for the Tier 3 Southeast London Healthy Living programme (SELHLP) in a diverse population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The SELHLP is a multicomponent, multidisciplinary programme that includes face\u2010to\u2010face (F2F) and virtual (V) delivery. Two management strategies are offered: Balance, a weight behavioural intervention and Kickstart, a three\u2010month total meal replacement intervention followed by a weight and behavioural intervention. Eligibility criteria were adults (\u2265\u200918\u2009years) with a BMI \u2265\u200935\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Baseline data and exit data were collected at session 9\u201312. Primary outcomes included weight change from baseline to programme completion; secondary outcomes included both clinical and behavioural outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Programme completers of both Balance and Kickstart were predominantly female (82% and 79% respectively). Among completers for Balance, weight change from baseline was \u22122.8 (8.4) kg for Balance F2F (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and \u22125.1 (11.7) kg for Balance V (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A similar trend was observed for Kickstart F2F \u221211 (13) kg and Kickstart V \u221211 (11) kg (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) but did not differ between service delivery models (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.005). 34% of participants of the combined Balance and Kickstart programmes lost \u2265\u20095% of initial weight, \u221210.7% and \u221218% weight loss respectively. Black participants and women were less likely to achieve \u2265\u20095% weight loss in both programmes, but deprivation status had no effect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The SELHLP resulted in significant weight loss, but weight loss varied by service delivery, ethnicity and sex. Future efforts should focus on cultural salience and digitisation of Tier 3 programmes to support better engagement and completion among participants of Black ethnicity. Tailoring of Tier 3 interventions and triaging of participants at the onset should be investigated to improve both patient and service outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/edm2.70215","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T04:17:11Z","timestamp":1775276231000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of and Comparative Outcomes for Digital and In\u2010Person Interventions for Complex Obesity in a Diverse Urban Population"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0204-3835","authenticated-orcid":false,"given":"Majella","family":"O'Keeffe","sequence":"first","affiliation":[{"name":"School of Food and Nutritional Sciences University College Cork  College Road Ireland"},{"name":"Department of Nutritional Sciences King's College London  London 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King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhys","family":"White","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Guys and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6284-8192","authenticated-orcid":false,"given":"Alastair","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences King's College London  London UK"},{"name":"Department of Nutrition and Dietetics, Guys and St Thomas' NHS Foundation Trust  London 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