Aspiring to new lows in North West waistlines

Guest post by Naoimh McMahon, Postgraduate student, NIHR CLAHRC NWC

In theory weight management is a ‘simple’ balance between consuming enough energy to adequately fuel ourselves and moving enough to ensure that extra energy is used up. However, in reality there is a complex web of influences that determine our eating and activity habits. We are becoming increasingly more sedentary and are prone to consuming more energy-dense foods. This combination is making the energy balance harder to achieve. When it comes to weight management interventions, what works for one individual is rarely guaranteed to work for the next and so there are real challenges to understand what the right mix of actions are to enable people to achieve and maintain a healthy weight.

Last summer, when preparing a doctoral fellowship application I met with providers and service users from a range of local health improvement initiatives in the North West of England. I was really intrigued by one initiative in particular called Aspire. Aspire is a weight loss programme delivered by a local charity. The design of the programme was unlike any other weight loss programme I had encountered and there was a real sense of personal investment in the programme from both the providers and participants. The thinking behind Aspire is that for individuals who have a lot of weight to lose, intensive and ongoing support is needed to make a positive and sustainable change. The programme runs for 26 weeks and each group has 12 participants. Aspire includes all the traditional elements that you would expect to find in a weight loss programme such as advice and education on food and healthy eating. It also supports participants, many of whom have a body mass index (BMI) of over 35, to engage in graded physical activity.

I think what I found most intriguing about this programme was the emphasis it placed on the person, trying to build confidence and esteem to really convince people that they could achieve their weight loss goals. For example one of the activities that participants spoke about with most feeling was a step climb in a local park at the beginning of the programme. The Aspire providers discussed how this activity served two purposes: (i) to act as a ‘shock to the system’ by allowing the participants to really reflect on their current fitness levels and (ii) to provide a goal to work towards and make a commitment that it will never be that hard again. The group returned to this step climb at the end of the 26 weeks with smart phones in tow and there is some really fantastic footage that captures the excitement and pride at the progress they had made along with the disbelief at how it had once taken hours to complete.

There is never a ‘one size fits all’ and any programme will work for some but not for others. It certainly seems like now it is less about finding a single ‘effective’ or ‘perfect’ programme and more about trying to understand what it is about programmes that enable different people to make positive and sustainable changes. I think we will all know people personally who have taken control over their weight by stumbling upon park runs and ‘getting the bug’ or by using commercial weight loss programmes such as Weight Watchers or Slimming World - finding a system that really works for them. Like other weight loss programmes, there were Aspire participants who did not achieve their goal weight and there were participants who regained the weight that they had worked so hard to lose. What is important is not to write-off such efforts as ‘ineffective’ but to get a better understanding of how and why these outcomes came about. Aspire is only one example of a novel approach to enable people to lose weight but there are certainly elements that have been particularly effective for some participants.


Find out more about the programme and how participants felt about what worked for them.