Obesity Update 2024: The impact of Roczen in an ethnically diverse population in the UK
We conducted a retrospective, real-world service evaluation. Patients were initiated on a 16-hour TRE plan with low-carbohydrate, moderate- protein dietary guidance.
The Roczen programme: Real-world data of a digitally enabled time restrictive eating programme on biometric outcomes in an ethnically diverse population in the UK
Laura Falvey1, Laurence J Dobbie2, Ling Chow1, Claudia Ashton1, Dipesh Patel1,3,4, Adrian Brown1,3, Jonathan TC Kwan1,5, Siri Steinmo1,6, Barbara McGowan1,71 ,Reset Health Ltd, London, UK2, King’s College London, London, UK3 University College London, London, UK4, Royal Free Hospital, London, UK5, Darent Valley Hospital, Kent, UK6 ,UCLH, London, UK7, Guys & St Thomas Hospital, London, UK
Introduction
Roczen is a digital, clinical programme designed for people living with obesity (PLwO) and complications such as type 2 diabetes (T2D) that utilises time-restricted eating (TRE). Weight management and metabolic health intervention data mostly includes people from white ethnicity1,2. The aim was to examine the impact of the programme in an ethnically diverse population in the UK at 12 months (12m).
Method
We conducted a retrospective, real-world service evaluation. Patients were initiated on a 16-hour TRE plan with low-carbohydrate, moderate-protein dietary guidance. The programme was digitally delivered by clinicians with regular video follow up, goal setting, self monitoring, motivational interviewing, feedback, and peer support via an App. Advice on increasing physical activity from baseline was tailored to the individual. We calculated mean±standard deviation to compare biometric outcomes in different ethnic groups.
Results
We included 945 patients (47.4±10.3 years, 64.6% female, BMI: 34.6±6.1kg/m2) who were at varying stages of the Roczen programme. 61.2% were from white ethnicity (n=578), 16.0% from black ethnicity (n=151), 14.1% from South Asian (SA) ethnicity (n=133) and 8.8% were from other ethnic groups (n=83). Of data available, mean weight loss was 8.6±7.1kg (-8.7%) at 12m (n=132, p<0.0001). At 12m, mean weight reductions were 6.0±6.3kg [-6.1%] in people from black ethnicity, 6.6±5.2kg [-7.9%] in people from SA ethnicity and 10.5±7.7kg [-9.9%] in people from white ethnicity (ANOVA: p=0.0052, BAC vs white: 4.4kg, p=0.01, SA vs white: 3.8kg, p=0.07). For available data on waist circumference, mean reduction was 10.1±10.5cm (9.3%) at 12m (n=70, p<0.0001), with similar reductions between ethnic groups (ANOVA: p=0.50, white: -10.6±10.5cm, black: -12.9±11.2cm, SA:-7.9±9.1cm). Retention rates at 12m were 46% in Black ethnicity , 28% in SA and 25% in WE groups.
Conclusions
Evaluation of the Roczen programme within a real-world setting shows that people from black and SA ethnicity appear to perform better than those from white ethnicity in terms of retention. Reductions in body weight in black ethnicity are less than in white ethnic groups, but all weight reductions were clinically significant. Waist circumference loss was highest in people from black ethnicity, but did not significantly differ between groups. Overall, our data shows the suitability of the programme for PLwO from diverse ethnic backgrounds.
References
- Robertson C, Aceves-Martins M, Cruickshank M, Imamura, M,Avenell, A. Does weight management research for adults withsevere obesity represent them? Analysis of systematic review data.BMJ Open 2022; 12 (5), Article e054459
- Haughton CF, Silfee VJ, Wang ML, Lopez-Cepero AC, Estabrook DP,Frisard C, Rosal MC, Pagoto SL, Lemon SC. Racial/ethnicrepresentation in lifestyle weight loss intervention studies in theUnited States: a systematic review. Preventative MedicineReports. 2018 (9) pp 131–137.
