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Treat physical inactivity as a disease, argues GP expert



By Lilian Anekwe

A GP has waded into the public health row by claiming that physical inactivity is a ‘disease in its own right’ and should be treated – and awarded QOF points.

The comments follow and outspoken attack by RCGP chair Professor Steve Field, who blasted the general public for bringing upon themselves a ‘tsunami of obesity’.

Dr Richard Weiler, a GP in Hertfordshire and specialist registrar in sport and exercise medicine, wrote in an editorial in the British Journal of Sports Medicine that obesity, though a disease, was often at least partly due to people not doing enough exercise.

The best way to tackle it, he argued, would be to offer new QOF points as an incentive for GPs to acknowledge ‘the relative importance of physical inactivity as a primary cause of many chronic diseases’, which he claimed ‘is largely neglected within modern medicine and by health strategy.

‘The lack of emphasis on physical activity as an individual [QOF] indicator provides mixed messages, negating its fundamental importance and rendering its promotion an afterthought.

‘Regular intervention built on existing real, longstanding primary care relationships may have a significant impact and effect on patients. It seems illogical that physical activity interventions remain neglected and unrewarded at the expense of other “recognised” risk factors, which are all symptoms of physical inactivity.

‘Given the significant associated mortality and morbidity, we propose that perhaps physical inactivity should also be considered for recognition as a disease in its own right.

He concluded with an appeal to policymakers to make use of GPs’ unique position to ‘to combat physical inactivity’.

‘Can we afford to leave physical activity promotion in primary care as the “would-be-nice” preventive option, offered typically in the form of unstructured advice by inadequately trained professionals?’

The NICE QOF indicator advisory committee has recommended that potential indicators on brief interventions for physical activity should be developed for piloting. If successfully developed and piloted indicators may be recommended for negotiations and inclusion in the 2012/13 Quality and Outcomes Framework.

Recent statements from health minister Anne Milton have encouraged GPs to call overweight people ‘fat’ to motivate them to lose weight and take more ‘personal responsibility’ for the consequences of their lifestyles.

GPs should be incentivised to encourage patients to take more exercise