Poster Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2023

Remote delivery of partial meal replacement for weight loss in people awaiting arthroplasty (#205)

Ritesh Chimoriya 1 , Justine Naylor 2 , Kimberly Mitlehner 1 , Sam Adie 3 , Ian Harris 2 , Anna Bell-Higgs 4 , Naomi Brosnahan 4 5 , Milan Piya 1 6
  1. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
  2. Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
  3. Faculty of Science and Engineering, Macquarie University, Macquarie Park NSW 2109, Sydney, NSW, Australia
  4. Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Campbelltown, Australia
  5. Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
  6. South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden and Campbelltown Hospitals, NSW, Australia

Background: This study aimed to assess the feasibility of remote delivery of a 12-week partial meal replacement (PMR) weight loss program for people living with obesity (BMI ≥30 kg/m2) awaiting total knee or hip arthroplasty.

Methods: This prospective cohort study included patients awaiting total knee or hip arthroplasty in a high-volume public arthroplasty centre in Sydney. The intervention included 12-week PMR plan of 1200 calories/day, with two meal replacement shakes and a third suitable meal option. Intervention support included online educational sessions, one-to-one teleconsultation, and access to a structured PMR App. The intervention was delivered remotely and supported by a team of dietitians, with access if required to a publicly funded weight management program. Outcomes included weight change, biochemical measures and patient-reported outcomes completed at baseline and 12 weeks. 

Results: Of the 107 patients contacted, 29 consented to participate, 26 started the program, and 22 completed the 12-week PMR plan. There was statistically significant weight loss from baseline to 12 weeks among completers, with paired difference of 6.3kg (95% CI: 4.8, 7.7; p<0.001), and 15/22 (68.2%) participants achieving at least 5% weight loss. Compared to baseline, there were statistically significant reductions in HbA1c and Low Density Lipoprotein (LDL) at 12 weeks. Based on questionnaires, there was a significant increase in the number of participants in the action and maintenance phases of readiness to change- diet, physical activity, and weight domains. Most participants who completed the program (18/22) reported that they were willing to pay for the service if provided on a long-term basis even after the completion of surgery.

Conclusions: This study demonstrated that significant weight loss is achievable for people awaiting arthroplasty following remote delivery of a 12-week PMR weight loss program. Despite the intervention being conducted remotely, the program was feasible and well accepted by people awaiting arthroplasty.