Alberga AS, Edache IY, Forhan M, Russell-Mayhew S Weight bias and health care utilization: a scoping review. Prim Health Care Res Dev. 2019; 20

Bennett G, Young E, Butler I, Coe S The Impact of Lockdown During the COVID-19 Outbreak on Dietary Habits in Various Population Groups: A Scoping Review. Front Nutr. 2021; 8

Bidstrup H, Brennan L, Kaufmann L, de la Piedad Garcia X Internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and biopsychosocial outcomes: a systematic review. Int J Obes. 2022; 46:(1)1-9

Blackburn M, Stathi A Moral discourse in general practitioners’ accounts of obesity communication. Soc Sci Med. 2019; 230:166-173

Blackburn M, Stathi A, Keogh E, Eccleston C Raising the topic of weight in general practice: perspectives of GPs and primary care nurses. BMJ Open. 2015; 5:(8)

Bray GA, Kim KK, Wilding JPH Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017; 18:(7)715-723

Dewhurst A, Peters S, Devereux-Fitzgerald A, Hart J Physicians’ views and experiences of discussing weight management within routine clinical consultations: A thematic synthesis. Patient Educ Couns. 2017; 100:(5)897-908

Dicken SJ, Mitchell JJ, Newberry Le Vay J, Beard E, Kale D, Herbec A, Shahab L Impact of COVID-19 Pandemic on Weight and BMI among UK Adults: A Longitudinal Analysis of Data from the HEBECO Study. Nutrients. 2021; 13:(9)

Forgione N, Deed G, Kilov G, Rigas G Managing obesity in primary care: breaking down the barriers. Adv Ther. 2018; 35:(2)191-198

Fruh SM Obesity. J Am Assoc Nurse Pract. 2017; 29:(S1)S3-S14

Gao M, Piernas C, Astbury NM, Hippisley-Cox J, O'Rahilly S, Aveyard P, Jebb SA Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective, community-based, cohort study. Lancet Diabetes Endocrinol. 2021; 9:(6)350-359

Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019; 393:(10184)1958-1972

Glenister KM, Malatzky CA, Wright J Barriers to effective conversations regarding overweight and obesity in regional Victoria. Aust Fam Physician. 2017; 46:(10)769-773

Gray L, Stubbe M, Macdonald L, Tester R, Hilder J, Dowell AC A taboo topic? How General Practitioners talk about overweight and obesity in New Zealand. J Prim Health Care. 2018; 10:(2)150-158

Gunther S, Guo F, Sinfield P, Rogers S, Baker R Barriers and enablers to managing obesity in general practice: a practical approach for use in implementation activities. Qual Prim Care. 2012; 20:(2)93-103

Hayward LE, Neang S, Ma S, Vartanian LR Discussing weight with patients with overweight: Supportive (not stigmatizing) conversations increase compliance intentions and health motivation. Stigma Health. 2020; 5:(1)53-68

Hazlehurst JM, Logue J, Parretti HM, Abbott S, Brown A, Pournaras DJ, Tahrani AA Developing Integrated Clinical Pathways for the Management of Clinically Severe Adult Obesity: a Critique of NHS England Policy. Curr Obes Rep. 2020; 9:(4)530-543

Jackson Leach R, Powis J, Baur LA, Caterson ID, Dietz W, Logue J, Lobstein T Clinical care for obesity: A preliminary survey of sixty-eight countries. Clin Obes. 2020; 10:(2)

Jastreboff AM, Kotz CM, Kahan S, Kelly AS, Heymsfield SB Obesity as a disease: the Obesity Society 2018 position statement. Obesity (Silver Spring). 2019; 27:(1)7-9

Kass L, Desai T, Sullivan K, Muniz D, Wells A Changes to physical activity, sitting time, eating behaviours and barriers to exercise during the first COVID-19 ‘Lockdown’ in an English cohort. Int J Environ Res Public Health. 2021; 18:(19)

Katz MH Regardless of age, obesity and hypertension increase risks with COVID-19. JAMA Intern Med. 2021; 181:(3)

Should we officially recognise obesity as a disease? [Editorial]. Lancet Diabetes Endocrinol. 2017; 5:(7)

Lawrence BJ, Kerr D, Pollard CM, Theophilus M, Alexander E, Haywood D, O'Connor M Weight bias among health care professionals: A systematic review and meta-analysis. Obesity (Silver Spring). 2021; 29:(11)1802-1812

Mazza D, McCarthy E, Carey M, Turner L, Harris M “90% of the time, it's not just weight”: general practitioner and practice staff perspectives regarding the barriers and enablers to obesity guideline implementation. Obes Res Clin Pract. 2019; 13:(4)398-403

McHale CT, Laidlaw AH, Cecil JE Primary care patient and practitioner views of weight and weight-related discussion: a mixed-methods study. BMJ Open. 2020; 10:(3)

Michie S Talking to primary care patients about weight: A study of GPs and practice nurses in the UK. Psychol Health Med. 2007; 12:(5)521-525

National Institute for Health and Care Excellence. 2014. (accessed 7 November 2022)

Nicholson BD, Aveyard P, Bankhead CR, Hamilton W, Hobbs FDR, Lay-Flurrie S Determinants and extent of weight recording in UK primary care: an analysis of 5 million adults’ electronic health records from 2000 to 2017. BMC Med. 2019; 17:(1)

Norman K, Chepulis L, Burrows L, Lawrenson R Barriers to obesity health care from GP and client perspectives in New Zealand general practice: A meta-ethnography review. Obes Rev. 2022; 23:(10)

Measured overweight (including obesity) rates among adults, by sex, 2019 (or nearest year). Health at a Glance 2021 OECD Indicators. 2021;

Obesity Empowerment Network. 2022. (accessed 7 November 2022)

Palad CJ, Stanford FC Use of people-first language with regard to obesity. Am J Clin Nutr. 2018; 108:(1)201-203

Parretti H, Chowhan H Guidance update. Overcoming challenges in managing obesity in primary care. Guidelines in Practice. 2021;

Puhl RM, Lessard LM, Himmelstein MS, Foster GD The roles of experienced and internalized weight stigma in healthcare experiences: perspectives of adults engaged in weight management across six countries. PLoS One. 2021a; 16:(6)

Puhl RM, Lessard LM, Pearl RL, Himmelstein MS, Foster GD International comparisons of weight stigma: addressing a void in the field. Int J Obes. 2021b; 45:(9)1976-1985

Robinson E, Boyland E, Chisholm A, Harrold J, Maloney NG, Marty L, Mead BR, Noonan R, Hardman CA Obesity, eating behavior and physical activity during COVID-19 lockdown: A study of UK adults. Appetite. 2021; 156

Royal College of Nursing. 2022. (accessed 7 November 2022)

Royal College of Physicians. 2015. (accessed 7 November 2022)

Segal L, Dalziel K, Bolton T A work force model to support the adoption of best practice care in chronic diseases - a missing piece in clinical guideline implementation. Implement Sci. 2008; 3:(1)

Sikorski C, Luppa M, Kaiser M, Glaesmer H, Schomerus G, König HH, Riedel-Heller SG The stigma of obesity in the general public and its implications for public health - a systematic review. BMC Public Health. 2011; 11:(1)

Tahrani A, Paretti H, O'Kane M, Chowhan H, Ratcliffe D, Le Brocq S Managing obesity in primary care. Guidelines in Practice. 2020;

Tartof SY, Qian L, Hong V, Wei R, Nadjafi RF, Fischer H, Li Z, Shaw SF, Caparosa SL, Nau CL Obesity and Mortality Among Patients Diagnosed With COVID-19: Results From an Integrated Health Care Organization. Ann Intern Med. 2020; 173:(10)773-781

Wharton S, Lau DCW, Vallis M Obesity in adults: a clinical practice guideline. CMAJ. 2020; 192:(31)E875-E891

Whitlock G, Lewington S, Sherliker P Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009; 373:(9669)1083-1096

World Health Organization. 2021. (accessed 7 November 2022)

Wilding JPH Beyond lifestyle interventions: exploring the potential of anti-obesity medications in the UK. Clin Obes. 2018; 8:(3)211-225

Williamson EJ, Walker AJ, Bhaskaran K Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020; 584:(7821)430-436

COVID-19 and Obesity: The 2021 Atlas. The cost of not addressing the global obesity crisis. 2021;

Supporting patients living with obesity in general practice

02 December 2022
Volume 33 · Issue 12


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.

Register now to continue reading

Thank you for visiting Practice Nursing and reading some of our peer-reviewed resources for general practice nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month