Year 2021
October 2021


Abstract Title
Combat Obesity in patients with chronic disease: Effective trans-disciplinary group weight management in primary care and community



NHG Polyclinics1

Background & Hypothesis

Obesity is a chronic progressive disease with rising global prevalence (WHO, 2016), and contributed to 6.4% of Singapore’s DALY in 2017. Lighter Life group programme targets overweight patients with chronic disease, where safe weight reduction improves disease control and reduces disease burden.


143 eligible patients were enrolled (Oct’18-Jun’20), with clinical measurements, and nutrition, exercise and empowerment surveys/scales administered. Propensity score matching was done for polyclinic control group with similar socio-demographics and disease status. Standardised mean difference was used to assess covariate balance. Primary (weight) and secondary outcome comparision (SBP/DBP/HbA1c/LDL/HDL/TG) was done.


Using 2-sample proportions test, treatment group who achieved ≥5%weight loss was 0.347 (control group 0.069 p<0.05) with 101 patients per group.

In treatment group, 65% reduced ≥3cm and 46% >5cm waist circumference.

Comparing average post-pre SBP and DBP change, treatment coefficient was -1.96 (p=0.22>0.05) and 0.40 (p=0.78>0.05) respectively, with 80 patients per group.

In treatment group:61% reduced ≥5mmHg SBP. 55% reduced ≥5mmHg DBP.

HbA1c treatment coefficient was -0.471(p=0.089>0.05), with 31 and 49 patients in treatment and control groups respectively.

82% of DM patients with ≥5%weight loss reduced HbA1c, as did 87% of those with 0.1-4.9%weight loss. 

No statistically significant treatment effect for LDL/HDL/TG.

In treatment group, 72% improved patient-empowerment scale, 56% improved nutritional-Fat score, 37% improved nutritional-Fibre Score; and 16% previously-inactive exercised ≥150min/week.

Discussion & Conclusion

Trans-disciplinary group weight management for patients with chronic disease is effective in weight loss, with high patient engagement and improved nutrition and exercise. Small sample size limited demonstration of clinical outcomes improvement. Prospective programme study underway.