GPs' obesity workload to grow under Darzi vision
By Lilian Anekwe
GPs will be expected to lead ambitious moves to cut the rate of obesity within a decade under SHA plans to overhaul provision of health services in line with Lord Darzi's vision for primary care.
NHS Yorkshire and the Humber, NHS East of England and NHS Southwest have all announced plans for GPs to lead on promoting lifestyle interventions as part of a commitment to halt and reverse the rise in obesity over the next five to 10 years.
But the plans for increased GP involvement in the management of patients with obesity come as new research shows lifestyle interventions have little impact on obesity in adults.
NHS Southwest will be pushing GPs to offer ‘evidence based behaviour change models', and GPs in NHS East of England's PCTs are set to ‘promote wellbeing to at risk groups' in order to prevent obesity and reduce health inequalities.
NHS Yorkshire and Humber, in its vision document, said GPs would be asked to teach patients ‘food skills' and promote leisure activities. It has also undertaken to offer a weight management service in each PCT for referral to by GPs.
But the policies may be undermined by a study which found that lifestyle interventions offered by GPs have limited effect on weight loss.
The systematic review of 39 studies assessed the use of long-term lifestyle intervention, and their impact on weight, risk factors and clinical outcomes in overweight adults with a BMI less than 35.
Dr Alison Avenell, a scientist in the Health Services Research Unit at the University of Aberdeen, presented her results, based on 60,000 adults, at the European Congress on Obesity in Geneva last week. She concluded: ‘Active interventions failed to show a significant effect on weight and there was no beneficial effect on mortality.'
Dr Gill Jenkins, a GPSI in obesity in Bristol, said patients needed to motivate themselves in order to lose weight – but added that ‘approval from above' would make funding GP referrals for obese patients easier.
‘I think it can often depend on how the practice is set up to deal with it. GPs have so little time to sit down with a patients and discuss lifestyle issues. Patients have to want to do it, as motivating someone takes an awful lot of effort and even then, you're not guaranteed success.
SHA obesity plans:
• NHS Yorkshire and Humber - weight management service in each PCT, encourage GPs to offer to teach patients ‘food skills' and leisure activities, enforcing the same criteria for bariatric surgery in all of its PCTs, halt rise in obesity over 10 years
• NHS Southwest - will be pushing GPs to offer ‘evidence based behaviour change models', reverse childhood obesity by 2013
• NHS East of England's PCTs are set to ‘promote wellbeing to at risk groups', decrease childhood obesity, halt and reduce the trend in obesity
Source: SHA Darzi plansObesity: Darzi vision set to add weight to GP workload Obesity: Darzi vision set to add weight to GP workload