AbstractsMedical & Health Science

The increasing prevalence of obesity has been accompanied by an increase in the number of individuals at the extreme end of the obesity spectrum. The detrimental impacts of extreme obesity, defined as BMI ≥ 40.0kg/m2, on affected individuals' physical and psychological health have not been fully established. Furthermore, it remains unclear whether medical and behavioural interventions are effective at facilitating weight loss for individuals with extreme obesity. The efficacy of two treatment pathways within the Heart of England NHS Foundation Trust Specialist Weight Management Service were examined, with both demonstrated to facilitate clinically and statistically significant weight loss. A detailed profile of the characteristics of individuals entering the service highlighted the substantial physical and psychological co-morbidity associated with extreme obesity, revealing widespread impairment in quality of life and mental health. A systematic review of primary research examining the efficacy of medical and behavioural weight management interventions within lesser-researched extreme obese populations demonstrated the value of medically-supported programmes and also revealed the limited body of good quality research. This thesis has enhanced current understanding of extreme obesity, and recommendations generated from this work have been made in order to improve primary research examining weight management interventions and service provision for affected individuals.