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Few obese patients offered weight loss interventions in primary care

Less than half of morbidly obese patients are given advice or treatment by their GP to help them lose weight, a study of primary care records has claimed.

The study, published in the journal BMJ Open, found nearly 60% of people with morbid obesity had no record of a weight management intervention over seven years.

Researchers said their findings suggested GPs lack confidence in weight loss interventions, but also that they do not have enough time and resources to treat obesity appropriately.

The team, from Kings College London, looked at the records of over 90,000 overweight and obese patients, over the period 2005 to 2012. Around 60% of the patients were overweight and 40% were obese, with 5% classed as morbidly obese.

Only one in 10 overweight patients had a record of being given advice, referred to weight management services or given an anti-obesity medication.  

This proportion increased at higher BMIs, but still only one in five obese (BMI 30-34.9), a quarter of severely obese (BMI 35-39.9) and two-fifths of morbidly obese (BMI of 40 or more) had a record of being offered some sort of weight loss intervention. Advice was the most common intervention in overweight patients, while anti-obesity drugs were the most common in severely and morbidly obese patients.

The team also found wide variation between practices, with 90% of patients in some areas receiving an intervention but none at all in others.

The researchers concluded the results ‘might be a consequence of poor documentation of advice’, but that they also ‘indicate a lack of clinician awareness or confidence in treating obesity’.

They added that that his could be linked to ‘lack of time in consultations, pessimism regarding potential success of weight loss attempts and increased use of medications to treat obesity-related risk factors and disease’.

Lead researcher Dr Helen Booth told Pulse the findings also suggested practices were too overburdened to cope with obesity management.

Dr Booth said: ‘Certainly the burden on primary care services is likely to be impacting on what services are offered and variation among regions.’

The report comes as the National Obesity Forum – chaired by Professor David Haslam, a practicing GP and specialist in obesity at the Centre of Obesity Research at Luton and Dunstable Hospital – urged the Government to ensure GPs receive additional training in obesity as well as better access to weight loss services on referral.

The Forum’s State of the Nation’s Waistline 2015 report welcomed NHS England’s commitment to tackling obesity as a priority in the Five Year Forward View, but called for a ‘cross-party commitment to tackle obesity from May’, the appointment of an ‘obesity tsar’ and for targets for reducing obesity levels by 2020 – and warned efforts to bring down obesity and diabetes levels would be ‘undermined’ without extra training and services for GPs to refer patients to.

The report said: ‘Without additional training for GPs and other frontline healthcare professionals, and increased availability of weight management services, the plans set out for the Five Year Forward View will be undermined.’

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