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GPs struggling to tackle weight loss issues with patients

Almost half of GPs have said they struggle with making interventions on patients’ diets, and have said a lack of will to tackle the problems in the food industry undermines efforts by the health service.

A Pulse survey of almost 600 GPs found that discussing steps to help patients lose weight were among the most difficult for GPs, with 45% highlighting diet as an issue and 35% saying that discussing physical exercise posed a problem.

One in four GPs also said they were overweight.

GPs explained that they didn’t feel their efforts would have an impact compared to the wider problems of availability of fast food, and also said complaints had become more common as a result of a growing ‘customer is always right’ attitude being instilled into the NHS.

Dr James King, a GP in Clackmannanshire, Scotland told Pulse: ‘Only the basics [on obesity interventions] are taught during training, no support from the rest of society in challenging behaviours of food industry, that are considerably more persistent and plausible than killjoy GPs’

While Dr Zishan Syed a GP in Maidstone, Kent told Pulse he was ensured he tailored interventions to each patient, but said generally: ‘Political interference means that now it is virtually impossible to tell people if they are following an unhealthy lifestyle.’

‘If you do so, even in as sensitive manner, then people can launch a complaint.  This is due to the government forcing a “customer is always right” mentality which is unsuitable in a healthcare setting. Let GPs do their job.’

Speaking in a personal capacity, Dr Margaret McCartney, a Glasgow GP and leader of the RCGP’s standing group on overtreatment and overdiagnosis, said that GP interventions were unlikely to make much difference.

The survey also found that just one in four GPs reported they were overweight.

This comes as England’s chief medical officer, Professor Dame Sally Davies, and chief executive of NHS England, Simon Stevens, have suggested NHS staff should be incentivised to lose weight.

But this is better than the UK average, where two-thirds of the population are overweight or obese, and GPs said that given the time demands and sedentary nature of the job there was no chance to take on exercise.

Dr King, told Pulse: ‘I would love an hour of protected time in my 12-16 hour day for exercise on site, with shower facilities etc. But there is no chance of that with pressure of work today.

‘The most important thing is public education and politicians becoming brave enough to take on the food industry, the way it has done with tobacco, and in Scotland alcohol industries.’

Other GPs said that there was a ‘lack of resources’ in their region to direct patients to for support and advice on weight loss, something which shadow health secretary Andy Burnham swore to address last week.

Mr Burnham said that ‘exercise on prescription’ would be the first port of call for all GPs, and would be nationally available as part of a bid to get 50% of the population taking recommended levels of exercise by 2025

Survey results

What area(s) of lifestyle change do you find difficult to give advice?

Alcohol abuse - 37%

Smoking - 21%

Physical activity - 35%

Diet - 45%

None - 27%

* Respondents could select more than one option so these totals do not add up to 100%

 

Are you overweight?

Yes - 25%

No - 73%

Don’t know - 2%

The survey launched on 10 September 2014, collating responses using the SurveyMonkey tool. The 28 questions covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to readers via our website and email newsletter, with a prize draw for a Samsung HD TV as an incentive to complete the survey. Some 560 GPs answered these questions.

 

Readers' comments (6)

  • Hazel Drury

    It amazes me how people confuse being "fit" with being overweight. Have you seen how far you have to run just t burn off the calories in 1 digestive biscuit? (About a mile). Exercise is part of a healthy lifestyle but ain't gonna make anyone lose any significant amount of weight. Good for their heart to support the extra weight though :-)

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  • Fat GPs? whatever next ? GPs with alcohol and mental health issues?

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  • I'm more than happy to discuss diet, weight management, body composition and exercise with any patient who initiates such discussion. However, given the dismal statistical likelihood of any individual maintaining weight loss, and the lack of evidence that exercise on prescription improves health outcomes, I'm not prepared to nag my patients to eat nasty food they don't like, shell out for slimming classes, and spend hours of their lives that they'll never get back in the gym.

    It's important that people should feel able to trust their doctors to manage their health issues in a compassionate and non-judgmental way irrespective of their body size. There are lots of reasons why people become very overweight (often it's a response to health problems) or don't engage in health-improving behaviours. It shouldn't make them fair game for institutional bullying within the NHS.

    And doctors and nurses are just human beings like everyone else. We come in different shapes and sizes, we get illnesses just like our patient do, and we have different interests and inclinations which don't stay constant throughout our lives. Having a BMI within the "healthy" range doesn't make someone a "better" doctor or nurse than one who has a BMI of 40. They're just a different size, that's all.

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  • Lorna- i wish you were my GP. What a wonderful attitude :)

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  • i cant believe doctors feel worried about discussiing diet and exercise with patients ove fear of complaints. who cares if people complain over such matters,. This is part of our job and of course it should be done sensitively but most people appreciate the advice and are unware that living on carbs is bad in my experience. no one wants to foce advice down someones throat we are all able to choose to live unhealthily but advice on how to change is often welcome.
    Again all this fear over complaints is our doing not the goventments, we write overly apologetic letters for things that arent our faiut when people complain or make ridiculous demands. if the patient is over weight and they have problems relating to this then we will discuss it. If you complain about this you are complaining about a GP doing their job.

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  • give us a magic want

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