GPs rarely use interventions for weight management in obese and overweight patients, study findsBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h142 (Published 13 January 2015) Cite this as: BMJ 2015;350:h142
Most obese and overweight patients are not offered weight management interventions by their GPs, an analysis of electronic patient records from UK practices has shown. The study found that very low rates of advice, referrals, or use of obesity drugs were recorded.
Researchers analysed the anonymised data for 91 413 adult patients with a body mass index of ≥25 kg/m2 recorded between 2005 and 2012.1 They were randomly selected from the Clinical Practice Research Datalink, which contains longitudinal data for more than 5% of the UK population, making it the largest primary care database in the world.
Results showed that 90% of overweight patients had no weight management interventions recorded in their notes during the seven years of the study. An intervention was more likely to be recorded in the health records of obese patients, but 80% of those in the lowest category of obesity (BMI 30-34.9 kg/m2) and more than half (59%) of patients in the most severe obesity category (morbid obesity, BMI >40 kg/m2) had no record of being offered advice or treatment for weight management.
The most common intervention recorded in all but the most obese patients was lifestyle advice, such as information on diet and exercise. Drug treatment was the intervention most frequently recorded in severely obese patients.
Further analysis showed little evidence of monitoring the progress of weight loss after an intervention had been offered. It was most likely to be recorded in patients referred to specialist services (34%), falling to one in five patients offered lifestyle advice and one in four patients offered an obesity drug. Where it was monitored no trend in weight change was observed in patients up to five years after any interventions were offered.
The researchers, led by Helen Booth, research associate at King’s College London, acknowledged that their findings might simply be the result of poor documentation. However, they point out that they “may indicate a lack of patient access to appropriate body weight management interventions in primary care.”
They concluded, “The results of this study suggest that primary care interventions given to patients with the aim of reducing weight are underutilised and that follow-up to determine their success is poor.”
Cite this as: BMJ 2015;350:h142