Authors' objectives: Behavioural weight management interventions are the main funded interventions for people living with obesity in the United Kingdom, but there is high intervention variability, including mode of delivery, dietary, physical activity and behavioural components. To map individual components of behavioural weight management interventions used in pragmatic clinical trials and those commissioned in the real world. To decide on the components which vary across the interventions and are hypothesised to be of importance to attendance, completion and weight loss.

Authors' results and conclusions: Real-world services providing data on 19 services and 6 randomised controlled trials were mapped using an intervention template. Survey and discussion led to expert group consensus of components for analysis within a meta-analysis. Summary descriptions are provided for each programme displaying variability in eligibility and exclusion criteria. Results provide a description of real-world services and randomised controlled trials, demonstrating variation between the programme components, for example, programme delivery (face-to-face group based was the most common answer for 28.6% randomised controlled trials and 63.2% real-world services), setting (community centre was the most common answer for 0% of randomised controlled trials and 69.2% real-world services) and total duration of the programme (12 weeks for 7.1% randomised controlled trials and 57.9% real-world services). Our work has provided an example of how standardized reporting of adult behavioural weight management interventions to aid evaluation can be implemented. Interventions were included in this study if they were compliant with National Institute for Health and Care Excellence guidance. We have described important differences between interventions used in randomised controlled trials and in existing services. The interventions vary in many components, particularly between real-world services and randomised controlled trials; United Kingdom trials differed to those delivered in the real world. This lack of evidence to inform decision-making as to the most effective components of behavioural weight management interventions will ultimately hamper the commissioning of such programmes.

Authors' methods: Cross-sectional survey. Behavioural weight management interventions in two separate scenarios: randomised controlled trials and real-world services (local authority and commercial) Mapping exercise of randomised controlled trials and real-world services using the standardized reporting  of adult behavioural weight management interventions to aid evaluation. Selection of components by expert group consensus derived from online survey and discussion. Mapping performed by a local contact for real-world services and by one BECOME researcher for randomised controlled trials. Study expert group provided their opinions via online survey and discussion. The standardised reporting template is lengthy and can take up to 1.5 hours to complete. The template for randomised controlled was not completed by the trials themselves. An expert group derived the components of interest, which could produce different results with a different group of people.

Project Status: Completed

URL for project: https://www.journalslibrary.nihr.ac.uk/programmes/hta/NIHR135916

Year Published: 2026

URL for published report: https://www.journalslibrary.nihr.ac.uk/hta/published-articles/JLGJ1630

URL for additional information: English

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: England, United Kingdom

DOI: 10.3310/JLGJ1630

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk