Support needs of patients with obesity in primary care: a practice-list survey

Abstract

BackgroundUK guidelines recommend that patients with obesity in primary care receive opportunistic weight loss advice from health care professionals, but there is a lack of research into the characteristics and existing weight management practices of these patients. The aim of this study was to characterise primary care patients with obesity in England, to inform the screening, support, and referral options appropriate to this group.MethodsWe surveyed 1309 patients registered at 15 GP practices in North East England, aged ≥18 years and with objectively recorded obesity (BMI ≥ 30 kg/m2). Study participants reported their weight history, health status, past and current weight loss activities, motivating factors, weight loss strategies used, professional support received, and perceived barriers to weight loss.Results62% of participants were actively trying to lose weight, and a further 15% had attempted and discontinued weight loss in the last 12 months. Only 20% of the sample had sought GP support for weight loss in the last 12 months; instead, most efforts to lose weight were self-guided and did not use evidence-based strategies. Those who sought GP weight loss support were likely to use it and find it motivating. Participants had attempted weight loss on multiple previous occasions and overall felt less confident and successful at maintaining weight loss than losing it. Participants at greatest clinical risk (higher BMI and more health conditions) reported particularly low confidence and multiple barriers to weight loss, but were nevertheless highly motivated to lose weight and keep it off.ConclusionsWe identified the need for informational, structural, and weight loss maintenance-specific support for GP patients with objectively-recorded obesity. Study participants were motivated to lose weight and keep it off, but lacked the confidence and understanding of effective strategies required to do this. GP weight loss support was acceptable and useful but underutilised, indicating that screening and brief referral interventions to structured programmes may augment patients’ current weight management activities and meet key support needs whilst optimising limited primary care resources.Electronic supplementary materialThe online version of this article (10.1186/s12875-017-0703-4) contains supplementary material, which is available to authorized users.

Desire to lose weight and need of weight loss support in the adult population—Results from a cross‐sectional study in Sweden

“…One of the advantages of the present study is that it is based on a considerable sample of the general population in a large geographical area and represents a wide age group of men and women from 30 to 69 years. Comparable findings on, for example, high motivation to lose weight among persons with obesity have also been found in other studies, 23,34 but these studies have been limited to health care patients. Although the study included only five counties, it covers the general adult population in these counties, comprising over one million inhabitants.…”

“…Multiple barriers to weight loss, such as high BMI, more health conditions, and low confidence among patients with obesity, have also been reported from a study conducted in primary care in the United Kingdom. 34 Thus, the results of the present study are relevant to the health care system in Sweden, but probably also in other countries.…”

Prevalence and predictors of weight loss maintenance: a retrospective population‐based survey of European adults with overweight and obesity

“…weight loss organisation names are country‐specific). Many of the questions have been used previously and successfully in a UK population‐based weight management survey .…”

“…5 : 2); attending a weight loss programme (e.g. commercial or health service); cooking more meals from scratch; reducing the frequency of eating out; eating smaller but more frequent meals; changing the timing of meals; reducing alcohol consumption; medication (prescription or other); and bariatric surgery (the latter two assessed for weight loss only) . For physical activity, they indicated whether they had become more active in everyday life, engaged in purposeful physical activity, attended a gym/fitness class/personal training sessions and decreased the amount of time spent sitting down.…”

“…Currently, 80% of NWCR members are female and mean WLM is 30 kg over 5.5 years . The design of these extant studies limits their generalisability, and most weight loss attempts occur outside formal settings , and so population‐based research is also needed. However, non‐RCT European studies tend to be small, include individuals across the whole BMI spectrum and focus on the prevalence and predictors of weight loss rather than WLM .…”