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NICE encourages GP obesity role

NICE has warned GPs that health care professionals must lead obesity interventions themselves, rather than recommending commercial and self-help programmes.

The institute's draft obesity guidance insists primary care must implement 'multicomponent interventions' to promote diet and exercise.

But the institute is set to spare GPs the workload of weighing and measuring all patients, instead recommending clinical judgment is used on when it is appropriate.

Primary care takes centre stage in the draft, which states: 'Appropriately trained health care professionals in all primary care settings must ensure that preventing and managing obesity is a priority action.'

NICE has chosen BMI over waist circumference to define obesity. BMI of 30 or above will mark obesity in mpst adults, although a lower figure of 25 is to be used in Asian patients.

'Health care professionals may use waist circumference as a valuable measure of central adiposity in adults with a BMI less than 35, although not alone due to high false-negative rates,' the draft states.

Patients with diabetes will no longer be expected to lose 5 per cent of their body weight in three months to continue on orlistat and sibutramine, following research showing they lose weight more slowly than other patients.

Dr David Haslam, clinical director of the National Obesity Forum and a GP in Watton-at-Stone, Hertfordshire, said: 'NICE has got to be followed by GPs but it's also got to be funded by PCTs. The times are changing with it being in the contract ­ the hope is it will be more in the contract in future.'

He added: 'It's disappointing that they're concentrating on BMI ­ waist circumference is a better measure.'

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