GPs ‘should stop worrying about offending obese patients’

GPs should stop worrying about causing offence and offer obese patients help to control their weight, experts have said.

GPs should feel free to recommend weight loss and exercise courses for obese and overweight patients, regardless of what ailment they present with, researchers found. (Photo: Getty)
GPs should feel free to recommend weight loss and exercise courses for obese and overweight patients, regardless of what ailment they present with, researchers found. (Photo: Getty)

If overweight people are seen at a surgery on an issue not related to their size, doctors should raise the issue and send them on a weight loss programme, they said.

The comments come after a new study found that GPs, who spent just 30 seconds engaging their patients about their weight, would produce beneficial results. The research, led by experts at the University of Oxford, saw 137 medics in England challenge almost 1,900 patients about their weight during routine consultations unrelated to weight loss.

At the end of the appointment, patients were randomly given one of two 30-second interventions. Half were offered a 12-week weight management programme free on the NHS. The other half were advised by their GP that losing weight would benefit their health.

The average weight at the start of the trial was approximately 105kg for men, and 93kg for women. Three quarters of those invited on the weight loss programme agreed to go and 40 per cent attended, according to the study published in The Lancet.

People who were referred to the programme lost an average of 2.4kg compared with 1kg in the control group. A quarter of participants in the referral group had lost at least 5 per cent of their body weight after a year, and 12 per cent had lost at least 10 per cent of their body fat – double the rate of the control group.

Four fifths of participants (81%) across both groups found the GP’s intervention “appropriate and helpful”.

Just 0.2 per cent found it “inappropriate and unhelpful”.

No reason for doctors to worry

“Doctors can be concerned about offending their patients by discussing their weight, but evidence from this trial shows that they should be much less worried,” said lead author professor Paul Aveyard, a practising GP.

“Our study found that a brief, 30-second conversation, followed by help booking the first appointment on to a community weight loss programme, leads to weight loss and is welcomed by patients.

“On average, people consult their doctor five times a year, meaning there is huge opportunity to deliver this low-cost intervention on a large scale.”

Dr Imran Rafi, Chair of Clinical Innovation and Research at the Royal College of GPs, said: “If this scheme is low cost and effective, which this research claims it is, it makes sense to consider it on a wider scale. However, the costs and benefits should be constantly evaluated in terms of patient care and the wider NHS.

“We must understand that while some patients in this study did benefit from a referral to a weight loss programme, it won’t work for everyone and shouldn’t be considered as a blanket solution to curb growing levels of obesity.”

What GPs should say

Patients who took part in the Lancet study heard their GP typically say: “While you’re here, I just wanted to talk about your weight…”

They were then told the best way to lose weight is to go to a course that is freely available on the NHS, such as Slimming World or Rosemary Conley. If they agreed, the GP would refer them immediately and ask them to return in four weeks to see how they were getting on.

The Royal College of GPs told i that while there are no official guidelines as to how to bring a patient’s weight up in conversation, it would often be part of a natural conversation given obesity is linked to so many physical ailments.

The RCGP recently launched its Physical Activity and Lifestyle programme it said will be a “clinical priority” over the next three years. It aims aims to support GPs and their teams to help manage their patients’ physical health, and ultimately reduce long-term pressure on the health service.

Source: i News