- Doctors rarely intervene with patients' weight because of lack of time, fear of causing offence or a belief that the intervention would be ineffective.
- Tackling obesity by offering the opportunity to attend a weight loss program during a routine consultation is effective.
- It is welcomed by patients and takes 30 seconds of physicians' time.
- This low cost intervention should be considered as the first point of call for GPs in tackling obesity.
This is found to be effective, welcomed by patients and takes 30 seconds of physicians' time, according to a new randomized trial of over 1800 people published in The Lancet.
‘Tacking obesity using GP referrals is not only effective in weight-loss but also comes at a cost lower than other available interventions for obesity, such as prescription pharmaceuticals.’
AdvertisementGuidelines recommend that physicians screen for obesity and offer referral to weight loss programs but doctors rarely talk to patients about their weight for fear of offending them, for the lack of time or belief that such interventions are ineffective.
The authors say the low cost intervention should be considered as the first point of call for GPs in treating obesity.
The trial, led by the University of Oxford (UK), included 137 GPs in England and 1882 people attending a consultation unrelated to weight loss.
At the end of the consultation, participants were randomly allocated to receive one of two 30-second interventions.
Half (referral group, 940) were offered a 12-week weight management program available for free on the NHS. The other half (control group, 942 people), were advised by their GP that losing weight would benefit their health.
All participants were weighed at the first consultation, then at 3 months they were asked whether they had taken any action to manage their weight. They were weighed again at 12 months.
The average weight at the start of the trial was approximately 105kg for men, and 93kg for women. People in the referral group lost on average 1.43kg more weight than those in the control group (2.43kg average weight loss in the referral group, compared to 1.04kg in the control group).
Furthermore, a quarter of participants in the referral group had lost at least 5% of their body weight after a year, and 12% had lost at least 10% - double the rate of the control group (table 4).
Importantly, the majority of people across both groups found the intervention appropriate and helpful, while only 0.2% found it inappropriate and unhelpful.
Over the 12 months of the trial, a similar proportion of people in both groups had taken some action to lose weight, but approximately five times more people in the referral group had taken effective action.
"Doctors can be concerned about offending their patients by discussing their weight, but evidence from this trial shows that they should be much less worried. Our study found that a brief, 30 second conversation, followed by help booking the first appointment onto a community weight loss programme, leads to weight loss and is welcomed by patients" says Professor Paul Aveyard, lead author, University of Oxford who is also a practising GP. "On average, people consult their doctor five times a year meaning there is huge opportunity to deliver this low cost intervention on a large scale."
The study took place across the south of England and the participants were slightly more affluent on average than England as a whole. The results are likely generalizable to other countries where similar weight loss programs are offered free of charge (eg, UK, Australia, Germany).
Given 40% attended the weight loss program, the cost of the intervention program is much lower than other available interventions for obesity, for instance prescription pharmaceuticals.