10 March 2025

Tell me about your role 

I'm the Professor of Clinical Endocrinology at King's College London, and alongside my research responsibilities I work clinically as a Honorary Consultant Physician and Endocrinologist at Guy’s and St Thomas’ NHS Foundation Trust (FT).  I’m also one of the KHP Diabetes, Endocrinology, and Obesity Clinical Academic Partnership co-Directors, and co-Director of Research along with Gav Bewick. 

I grew up in Canberra and then trained in medicine at University of Sydney before moving to Oxford in 1994. Along the way I completed a PhD in the genetics of osteoporosis, before returning to Australia in 2005 when our eldest was starting school. Our youngest finished school in 2019; and I moved back to the UK - mid-pandemic – in May 2020. The dog came too, as he is our last child-at-home.

What is digital weight management? 

A digital weight management service uses the communication technologies we use every day – mobile phones, computers, apps, smart watches – to help deliver high-quality health care for people living with obesity, affordably and equitably. The specific service we are working with is called Roczen, which is a clinician-led and NICE-recommended digital programme that has already been shown to be safe, effective, and cost-efficient in helping individuals living with obesity, and which delivers care working alongside the NHS. However, there has been no head-to-head comparison of Roczen with conventional weight management services (such as face-to-face appointments) with respect to health outcomes - including achieving and sustaining a healthy weight, and improving quality of life – as well as patient and clinician experiences.   

How does digital weight management compare with a standard service?  

This is the core question of this work! Together with Dr Andrew Walker from the Health Innovation Network South London (HIN SL), I am co-leading a three-year study funded by the NIHR Invention for Innovation (i4i) Programme, to answer the question: “How does a digital weight management service compare to our existing gold-standard Guy’s and St Thomas’ NHS FT obesity clinics in south east London, for people living with obesity?”.    

My involvement in the study really was a matter of right place, right time — a lot of which was thanks to my involvement with KHP Diabetes, Endocrinology and Obesity. I am contributing my research skills and experience, as well as my clinical experience as an endocrinologist, to design and deliver a robust study to help answer this important question. However, our grant truly is a collaboration – between our patient participants, the obesity service at Guy’s and St Thomas’ NHS FT, the health innovation network, and King’s College London. Together we will compare differences in weight loss, quality of life, and cost effectiveness between Roczen and the existing conventional service. We will also use machine learning to help identify characteristics that might predict who might fare better with a digital service and whose needs might be better served with a more traditional clinical service.  

Ultimately, we hope our study will help to personalise obesity services for people according to their needs, to achieve the best possible outcomes for every individual. 

How could digital weight management help patients? How could this study address health inequalities?  

A digital service can help address the barrier of long waiting lists, by giving people immediate access to care. Also, a digital service is not restricted by location – although our current study is based in south east London, ultimately it would not matter whether someone lived at John O’Groats or Land’s End: they would still be able to access a gold-standard weight management service. Currently around half of the UK’s population has no access at all to specialist weight management services, so a digital service would help alleviate this postcode lottery and improve healthcare access equity. 

For many people, also, attending clinics during conventional working hours is difficult, and many people have to juggle their working hours and family responsibilities against making the time to address their own health needs. These sorts of issues make it really hard for people to access a service, even when an excellent service is available. A digital service offers flexibility, removing the need to travel long distances or take time off work.  

Importantly here, mobile phone usage is nearly universal in the UK, regardless of socioeconomic background, making this an accessible option for many. Digital services may also improve engagement, particularly among men, who often seek healthcare later than women, leading to poorer healthcare outcomes. By making healthcare more accessible, digital services could contribute to better health for all genders. 

And lastly, there is a real stigma around obesity and acknowledging obesity as a health issue. Creating the opportunity for people to access a weight management service discreetly, without having to come into hospital and sit in a clinic labelled as “the obesity clinic”, may reduce the stigma incurred simply by the process of accessing weight management services. 

How is partnership working benefitting this study?  

King's Health Partners makes it easier to do translational research between two healthcare institutions and King’s College London. The study has been brought to life by collaboration, especially through engagement with our patient partners. It's been great working together and sharing the same aim — to deliver a better service for all.  

This study has been brought to life by collaboration - our patient partners, King’s College London, the Health Innovation Network, and Guy’s and St Thomas NHS FT. And I would particularly to highlight the support of the King's Health Partners Diabetes, Endocrinology and Obesity team, which made it easier for us to create and deliver this translational research. It's been great working together and sharing the same aim — to deliver a better service for all.   

Find out more about the work of KHP Diabetes, Endocrinology and Obesity.