Multidisciplinary teams are needed throughout UK to manage obesity

BMJ 2013; 346 doi: (Published 01 January 2013) Cite this as: BMJ 2013;346:e8679
  1. Zosia Kmietowicz
  1. 1BMJ

The United Kingdom’s obesity epidemic requires a national and concerted response similar to that which has developed in the past 50 years to tackle smoking, doctors have said.1

A working party from the Royal College of Physicians has said that every hospital trust should have a lead doctor on obesity to work with commissioning groups, be a source of information for patients, and act as a link between the hospital and the community.

And there should be a national lead on obesity to drive a coordinated government strategy within and across departments, including health, the Treasury, education, agriculture, work and pensions, and local government, said the working party’s report.

With a prevalence of 25% in adults, the UK has one of the highest rates of obesity in the world, and the cost of dealing with its adverse effects is set to double by 2050, from an estimated £5bn (€6.1bn; $8.1bn) a year at present. However, the multidisciplinary services needed to manage patients who were overweight were poorly developed and “extremely patchy,” says the report.

In 2011 the NHS Atlas of Variation in Healthcare found that the rate of bariatric procedures carried out in hospitals, such as gastric banding, ranged from 0.4 per 100 000 population in some primary care trust areas to 41.3 per 100 000 in others.2

Few coordinated services existed for people who were overweight and who may also have coronary heart disease, diabetes, arthritis, sleep disorders, and gynaecological disorders, the report said. Multidisciplinary teams made up of physicians, surgeons, nurses, and other health professionals must be available throughout the UK to deal with this problem, it recommended.

In addition, medical students needed to learn more about obesity and nutrition, and all specialist postgraduate exams should include components on obesity and training in behavioural change therapy.

The report also advises that a group be set up, to be based at the college. This, like Action on Smoking and Health, which the college set up in 1971, could meet regularly and oversee the development and implementation of the working party’s recommendations.

John Wass, chairman of the working party and academic vice president of the Royal College of Physicians, said, “Britain is getting bigger, and while we try to prevent the increase in obesity we must also prepare the NHS for the influx of patients presenting with severe complex obesity.

“A patient may arrive at my hospital with coronary heart disease, but if the root cause of their condition is obesity we must be equipped to deal with that root cause.”

Commenting on the report, Lindsey Davies, president of the Faculty of Public Health, said, “The only way we will ever tackle the problems caused by obesity is by everyone working together. Obesity is not only caused by how much we each eat or drink. If tackling it were as simple as telling people to eat less and move more, we would have solved it by now.

“Our chances of being obese are also affected by factors like whether we have easy access to affordable fruit, vegetables, and other healthy foods and if it is safe to let our kids play outside. That’s why . . . a government focus on personal choice alone is, at best, a red herring and, at worst, a dereliction of duty for everyone’s health.”


Cite this as: BMJ 2013;346:e8679