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NICE wants GPs to be lifestyle gurus

GPs face being trained up as lifestyle gurus as part of a new drive by NICE to prioritise obesity in primary care, writes Gareth Iacobucci.

New guidance, which the institute described as the most important it had ever put out, places general practice firmly at the heart of moves to tackle the obesity epidemic.

All overweight adults with a BMI under 35 should now have their waist circumference measured, NICE says. New charts let GPs assess risk by combining BMI and waist measurements.

GPs will also be expected to pressure parents into making lifestyle changes in their children, while anti-obesity drugs are recommended in children for the first time.

And GPs will have to source weight management schemes themselves, with self-help, commercial or community-based schemes only to be recommended where they meet 'best practice standards'.

The proposals split GPs, with some supportive but others calling them 'the nanny state gone mad'.

Professor Paul Little, a member of the NICE guideline group and a GP in Southampton, said scepticism from GPs was understandable after the 'abject failure' of previous schemes, and insisted 'extra training' would be needed.

But Professor Little, who is professor of primary care research at the University of Southampton, added GPs needed to 'gradually work towards a situation where we can help'.

Dr David Haslam, clinical director of the National Obesity Forum and a GP in Watton-at-Stone, Hertfordshire, said managing obesity in children in particular was difficult.

But he welcomed the introduction of waist measurement, saying it was more effective than BMI as a direct marker of fat, except in children.

Dr John Leigh, a GP in Washington, Tyne and Wear, said expecting GPs to change patients' lifestyles was 'ridiculous'.

'This is the nanny state gone mad. They might as well make us responsible for car crashes.'

• For evidence-based advice on obesity, visit Searchmedica.co.uk

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