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Dr Amanda Lewis briefly tells us about her work, and that of the Behavioural Medicine Research Group. The research group is part of the Nuffield Department of Primary Care Health Sciences and is located in New Radcliffe House, Radcliffe Observatory Quarter and the Blackwells building on Hythe Bridge Street.

Extracted from Issue 5, January 2014 OxfordMedSci News.

Tell us a little about the work in your research group

Behavioural Medicine Research Group memberBehavioural medicine is the integration of biological, psychological and sociological knowledge to prevent and treat disease and to aid rehabilitation. The aim of our research is to look at changing people’s behavior and the culture to either prevent or treat serious disease. We currently have three main areas of focus: interventions to help people stop or reduce their smoking and manage their weight (reduce weight and maintain weight loss) by adopting a healthier lifestyle and following different weight management strategies; and exploring the role and effectiveness of eHealth, such as using email to communicate between doctors and patients. We are very conscious that our work is destined for primary care, so the interventions we develop need to be simple and quick to implement because of the short time that practitioners have with each patient. 

Tell us a little bit about your work within the research group, why it is important and what the implications of your research are

BWEL logoI am a postdoctoral research fellow and co-principal investigator of the BWeL trial - Brief interventions for Weight Loss.

Behavioural Medicine Research Group memberCurrently, 25% of the UK’s adult population is obese, however no NHS treatment service exists to address this issue and GPs rarely discuss weight management with patients or support behavior change. Evidence demonstrates the effectiveness of brief, opportunistic interventions by GPs for tobacco control and problem drinking. To our knowledge no trial has examined whether screening to identify overweight or obese adults and brief interventions are effective. Hence the BWeL trial, which is a randomised controlled trial to examine the effectiveness of a brief, opportunistic intervention for weight management and the active engagement of GPs in supporting weight loss in obese adults in primary care. We aim to recruit 1824 obese adults from about 60 GP practices in England. Specifically, we recruit patients who are attending their GP for reasons other than weight management and randomise them to one of two interventions: the GP will either encourage weight loss to benefit health (advice-control) or offer referral to a commercial weight management service available in the NHS (e.g. Slimming World or Rosemary Conley) and a follow up review session one month later (assistance-intervention). The main outcome is weight change at one year (Trial details can be found here). Our hope is that the results of the trial could make the case for brief interventions for obese people visiting their doctors. If successful, the intervention could also be introduced in the GPs’ pay for performance structure, the Quality and Outcomes Framework, and influence weight management practice worldwide.

 What’s a typical day at work like for you?

Behavioural Medicine Research Group memberNo one-day is ever the same; it can range from conducting literature reviews, visiting research participants to collect data, conducting data analysis, forming new research questions and completing grant applications for future funding, writing and reviewing articles for publication, supervising students or teaching.

Besides BWeL, I am involved in research about: preventing weight gain during pregnancy; the use of attentive eating strategies to lose or maintain weight; and investigating different dietary strategies to lose weight, such as the 5:2 diet and the use of very low calorie diets, in obese adults. I also co-supervise a PhD student who is exploring different cognitive and bahavioural approaches to weight control, in particular regular weighing and self-monitoring techniques. Furthermore, I teach for a MSc programme at Warwick Medical School. Oh, and I recently chaired the local organising committee for the 9th Annual Scientific Meeting for the UK Society for Behavioural Medicine (UKSBM).

(Image: Dr Amanda Lewis)

How do you see your field/area of research developing in the near future?

Behavioural Medicine Research Group membersThe problem of obesity is not going away anytime soon; we have to think about how we can prevent more people from becoming overweight and obese, as well as treating those who are already overweight and obese.

Our research has previously shown that commercial weight loss providers are effective and cheap for the NHS but not everyone will want to use or succeed using these interventions. No other intervention delivered in primary care has yet shown evidence of effectiveness. We are looking for those elusive low intensity yet effective interventions, using the best science to develop and test interventions based on an understanding of both clinicians’ and patients’ behaviours. Through our research, we continue to aim to improve the health care provided to patients, and ultimately the health of the nation.

(Image: Members of the Behavioural Medicine Research Group)