This article has a correction

Please see: Request for slimming tablets

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

  1. S W Mercer, professor of primary care research1,
  2. M E J Lean, professor of human nutrition2
  1. 1General Practice and Primary Care, Division of Community-based Sciences, Faculty of Medicine, University of Glasgow, Glasgow G12 9LX
  2. 2Human Nutrition, Division of Developmental Medicine, Faculty of Medicine, University of Glasgow
  1. Correspondence to: S Mercer s.mercer{at}clinmed.gla.ac.uk
  • Accepted 31 May 2007

A 43 year old hairdresser who has recently moved into the area after a divorce asks you for slimming pills. Medical records from her previous GP shows that she rarely consults doctors.

What issues you should cover

Optimal management of obesity combines diet, exercise, lifestyle advice, and, where necessary, pharmacotherapy and surgery. Current drugs used in weight management are not the “slimming pills” used many years ago. However, they are all expensive and should be used rationally within structured management programmes. Shared care between the GP and a practice nurse trained in weight management may make the management of obesity in primary care more feasible.

Explore the request in a non-judgmental way

Whether the patient looks overweight or not, find out why she is requesting the pills. Often patients will present because of an impending social or personal event (a wedding or holiday). What exactly does she know about slimming tablets? Where did the information come from? What does she expect from them? Has she ever taken them in the past and, if so, who prescribed them? Has she taken any recently?

Take a history

Take a detailed history of her weight and weight gain. …

Access to the full text of this article requires a subscription or payment

Subscribe

Article access

Article access for 1 day

Purchase this article for £20 $30 €32*

The PDF version can be downloaded as your personal record

* Prices do not include VAT

Rapid responses

THIS WEEK'S POLL

BMJ most popular