Current approaches to obesity management in UK Primary Care: the Counterweight Programme

Gibbs, H.D., Broom, J., Brown, J., Laws, R.A., Reckless, J.P.D., Noble, P.A., Kumar,S., McCombie, E.L., Lean, M.E.J., Lyons, F.G., Frost, G.S., Quinn, M.F., Barth, J.H., Haynes, S.M., Finer, N., Ross, H.M., Hole, D.J. and Montazeri, A. 2004, Current approaches to obesity management in UK Primary Care: the Counterweight Programme, Journal of human nutrition and dietetics, vol. 17, no. 3, pp. 183-190, doi: 10.1111/j.1365-277X.2004.00528.x.

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Title Current approaches to obesity management in UK Primary Care: the Counterweight Programme
Author(s) Gibbs, H.D.
Broom, J.
Brown, J.
Laws, R.A.ORCID iD for Laws, R.A.
Reckless, J.P.D.
Noble, P.A.
McCombie, E.L.
Lean, M.E.J.
Lyons, F.G.
Frost, G.S.
Quinn, M.F.
Barth, J.H.
Haynes, S.M.
Finer, N.
Ross, H.M.
Hole, D.J.
Montazeri, A.
Journal name Journal of human nutrition and dietetics
Volume number 17
Issue number 3
Start page 183
End page 190
Total pages 8
Publisher Wiley
Place of publication London, Eng.
Publication date 2004-06
ISSN 0952-3871
Keyword(s) anti-obesity medication
general practitioner
patient literature
practice nurse
primary care
treatment models
Summary Background/Aims Primary care is expected to develop strategies to manage obese patients as part of coronary heart disease and diabetes national service frameworks. Little is known about current management practices for obesity in this setting. The aim of this study is to examine current approaches to obesity management in UK primary care and to identify potential gaps in care.

Method A total of 141 general practitioners (GPs) and 66 practice nurses (PNs) from 40 primary care practices participated in structured interviews to examine clinician self-reported approaches to obesity management. Medical records were also reviewed for 100 randomly selected obese patients from each practice [body mass index (BMI) ≥30 kg m−2, n = 4000] to review rates of diet counselling, dietetic or obesity centre referrals, and use of anti-obesity medication. Computerized medical records for the total practice population (n = 206 341, 18–75 years) were searched to examine the proportion of patients with a weight/BMI ever recorded.

Results Eighty-three per cent of GPs and 97% of PNs reported that they would raise weight as an issue with obese patients (P < 0.01). Few GPs (15%) reported spending up to 10 min in a consultation discussing weight-related issues, compared with PNs (76%; P < 0.001). Over 18 months, practice-based diet counselling (20%), dietetic (4%) and obesity centre (1%) referrals, and any anti-obesity medication (2%) were recorded. BMI was recorded for 64.2% of patients and apparent prevalence of obesity was less than expected.

Conclusion Obesity is under-recognized in primary care even in these 40 practices with an interest in weight management. Weight management appears to be based on brief opportunistic intervention undertaken mainly by PNs. While clinicians report the use of external sources of support, few patients are referred, with practice-based counselling being the most common intervention.
Language eng
DOI 10.1111/j.1365-277X.2004.00528.x
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2004, Wiley
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