GPs can do more to help patient weight loss
Primary care approaches to obesity need a rethink with GPs providing more support for patient weight loss, according to
two University of Auckland public health academics.
In an editorial published today in leading medical journal, The Lancet, Professor Boyd Swinburn (Professor of Population
Nutrition and Global Health) and Professor Bruce Arroll
(Professor of General Practice) discuss a new study in the same issue that provides optimistic news for the primary care
management of obesity.
The UK study found a net weight loss benefit (of 1.43 kg) at 12 months from a 30-second active intervention by primary
care physicians.
“A striking feature was that patients with obesity were invited to participate with no assessment of readiness to change
yet the majority (83 percent) were willing to do so,” says Professor Arroll.
The active intervention group was offered a specific appointment (made before leaving the clinic) to a weight management
group and the advice-only (control) group was simply advised that their health would benefit from weight loss.
“It is surprising that this is the first study in primary care to undertake a brief intervention for obesity,” he says.
“This may reflect the nihilism about weight loss that pervades medical care.”
“A primary care system which makes weight a vital sign by actively monitoring weight in all patients and communicating
the benefits of normal growth trajectories for children and no age-related weight gain for adults - would go a long way
to fulfilling its population health potential to prevent to the weight-related health problems which fill up its waiting
rooms,” says Professor Arroll.
“This study should trigger a rethink of the primary care approaches to obesity,” says Professor Swinburn. “Far from
being trivial, a one kilogram weight loss or even no weight gain applied at the population level could help to reduce
the enormous burden that obesity places on health systems.”
“We need to rethink how to work on the systems for primary care to achieve both clinical and population outcomes,” he
says.
They concluded that while mass, population-wide weight loss was not a plausible strategy, preventing age-related weight
gain in the adult population was one.
ENDS