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Commons committee slates inaction on obesity

BMJ 2004; 328 doi: http://dx.doi.org/10.1136/bmj.328.7452.1335 (Published 03 June 2004) Cite this as: BMJ 2004;328:1335
  1. Tiago Villanueva
  1. BMJ

    Primary care trusts should improve the way they deal with obesity, says a report on obesity published by the House of Commons Health Committee.

    Trusts have not been giving obesity as much priority as they should, says the committee, which also criticises the government's performance on obesity and the food industry for its role in encouraging bad eating habits.

    In criticising primary care trusts for failing to tackle obesity, the report cites examples of GPs being asked by trusts to limit their prescribing of drugs that have been approved by the National Institute for Clinical Excellence for obesity, specialist obesity services with closed waiting lists, and pioneering local projects threatened with closure because of lack of funding.

    The report also recommends that primary care trusts press the government to implement measures that will enable them to serve their communities appropriately.

    It says the government does not seem keen on committing itself to further national service frameworks that set priorities for key areas of health.

    The national service frameworks, it says, have concentrated mainly on the management of discrete disease areas, focusing on the consequences of diseases such as cancer and diabetes rather than looking at the factors contributing to these diseases, such as obesity.

    The committee heard evidence that many general practices were not dealing with obesity because of their obligation to meet targets in the national service frameworks for coronary heart disease and diabetes. The committee pointed out, however, that dealing with obesity would have a positive impact on such “competing” disease areas.

    The report recommends the creation of a strategic framework on prevention, health promotion, and treatment in the NHS, which could further develop the obesity measures already included in the specific national service frameworks. It says such a framework would be in tune with the guidance of the National Institute for Clinical Excellence on prevention, identification, evaluation, and treatment of overweight and obesity, which is due to be published in 2006.



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    Half of all children in England could be obese by 2020

    Credit: LELAND BOBBE/PHOTONICA

    The institute's guidance would thus be supported by public health targets, such as bringing waiting times for specialist obesity services in line with all other NHS specialties.

    Dr Richard Taylor, a member of the health committee, said doctors could implement a set of simple measures that could make a lot of difference. He suggested that practices take a record of weight and body mass index when overweight patients visit. He also stressed the importance of making people aware of the risks of obesity and of increasing the number of specialist obesity clinics in primary care, to the point of having one in each primary care trust area.

    David Hinchliffe, chairman of the committee, said, “The devastating consequences of the epidemic of obesity are likely to have a profound impact over the next century. Obesity will soon supersede tobacco as the greatest cause of premature death in this country.

    “It is staggering to realise that on present trends half of all children in England in 2020 could be obese. Already a third of children in America are likely to become diabetic.

    “Our inquiry is a wake up call for government to show that the causes of ill health need to be tackled by many departments, not just health.”

    Obesity: Third Report of Session 2003-04 is at www.publications.parliament.uk/pa/cm/cmhealth.htm