Supporting patients living with obesity in general practice
General practice is ideally suited to support patients with weight management. Hilda Mulrooney outlines some of the barriers facing nurses working in general practice and ways to overcome these
Primary care is identified in national guidance as fundamental to supporting patients living with overweight and obesity. Despite this, weight is not routinely recorded and many practitioners are ambivalent about their role in this area. Barriers to addressing excess weight in primary care have been identified by patients and healthcare practitioners. This article outlines some of the barriers identified by both groups. In addition, approaches and resources which may help health professionals overcome barriers are suggested.
For many reasons, general practice is ideally suited to support weight management. It is the first port of call for patients, and often the gateway to other services. In England, 28.3 million GP appointments were booked for September 2022, the majority (68.2%) face-to-face (BMA, 2022). Tiered obesity care pathways in the UK rely on the active involvement of community-based healthcare practitioners (Wilding, 2018). Tier 1, commissioned by local authorities, has a universal prevention focus, promoting healthy eating, physical activity and behaviour change. It is delivered in the primary care setting by GPs, and school, practice and community nurses, among others (Obesity Empowerment Network (OEN), 2022). Tier 2, also commissioned by local authorities, provides lifestyle weight management services, referred into by primary care staff (OEN, 2022). Increasingly, community care services delivered locally (eg by community podiatrists, physiotherapists and speech and language therapists, as well as district and school nurses) help to reduce pressure on secondary care and embed services in the community. An estimated 100 million patient contacts are made by community care services annually, with important benefits for patients including local health promotion and management of long-term conditions (Charles, 2019). General practice can reach people in their local areas, is more likely to see patients regularly and, therefore, has the potential to establish relationships which support healthful behaviour change.
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