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GPs can do more to help patient weight loss

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.


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