Train GPs in compassion to tackle obesity, says NICE

GPs should be given extra training in communication skills to help them treat overweight and obese patients 'confidently but with empathy', NICE has said.

GPs should routinely raise weight issues with patients, says NICE (Photo: JH Lancy)
GPs should routinely raise weight issues with patients, says NICE (Photo: JH Lancy)

New guidance from the institute says GPs will be expected to ‘routinely’ raise the issue of weight loss in a ‘respectful and non-judgemental way’ to patients, even during unrelated appointments.

NICE said raising and treating weight issues should be added to competence training and CPD for GPs.

The guidance, Managing overweight and obesity in adults, stresses that even a modest weight loss of 3%, kept off for life, can improve or prevent health problems including heart disease and diabetes.

It says GPs should identify people eligible for weight management services by measuring BMI, as well as weight circumference in those with a BMI under 35.

Obese patients with a BMI over 30 should be considered for funded referral to lifestyle weight management services. Overweight patients with a BMI between 25-30 should not be denied appropriate access to weight loss services where there is capacity.

The advice forms part of 18 recommendations aimed at GPs, other health professionals, commissioners, and providers of weight management programmes.

GPs should also provide patients with information on lifestyle weight management programmes, and emphasise the importance and benefits of making gradual, long-term changes to their diet and physical activity levels.

'A very sensitive issue'

The nutritionist experts who developed the guidelines said many patients reported feeling unable to raise issues about their weight for fear of being blamed or judged. They said the best approach to encourage them to lose weight was for GPs and other health professionals to be understanding and supportive.

NICE's guidance said those responsible for setting competences and CPD programmes should 'train GPs and other health and social care professionals to identify when to raise weight management with someone and to do so confidently, but with empathy'.

It added: 'They should understand why many adults have difficulty managing their weight and the experiences they may face in relation to it. This includes considering the effect of their attitudes to, and any concerns about, their own weight.'

Gill Fine, nutritionist and chair of the group who developed the guidance, said she was aware that some GPs may find it ‘awkward’ to raise the subject of weight, as ‘it can be a very sensitive issue’. She said the guidelines should give GPs ‘some guidance on how that might be done’.

She added: ‘Obesity in itself is a risk factor for so many conditions [that GPs] will be dealing with, so it’s a really important issue to address. It’s all part and parcel of helping people to understand why it’s important to lose some weight and keep that weight off.’

Professor Mike Kelly, director of the Centre for Public Health at NICE, said: 'Lifestyle programmes are one part of the solution. An environment that makes it easier for people to be active and eat well is also crucial, as are services for people with other issues that affect their health and wellbeing. The guidance isn’t about quick fixes. There is no "magic bullet". It is about ensuring effective services are there to support people in the long term.'

Obesity-related disease costs the NHS around £5.1bn a year.

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