Abstract

BackgroundCurrent guidelines recommend that patients attending general practice should be screened for excess weight, and provided with weight management advice.ObjectiveThis study sought to elicit the views of people with overweight and obesity about the role of GPs in initiating conversations about weight management.MethodsParticipants with a body mass index ≥25 were recruited from a region in Australia to take part in a Community Jury. Over 2 days, participants (n = 11) deliberated on two interconnected questions: ‘Should GPs initiate discussions about weight management?’ And ‘if so, when: (a) opportunistically, (b) in the context of disease prevention, (c) in the context of disease management or (d) other?’ The jury deliberations were analysed qualitatively to elicit their views and recommendations.ResultsThe jury concluded GPs should be discussing weight management, but within the broader context of general health. The jury were divided about the utility of screening. Jurors felt GPs should initiate the conversation if directly relevant for disease prevention or management, otherwise GPs should provide opportunities for patients to consent to the issue being raised.ConclusionThe jury's verdict suggests informed people affected by overweight and obesity believe GPs should discuss weight management with their patients. GPs should feel reassured that discussions are likely to be welcomed by patients, particularly if embedded within a more holistic focus on person‐centred care.Public contributionMembers of the public took part in the conduct of this study as jurors, but were not involved in the design, analysis or write‐up.

Highlights

  • Obesity is a risk factor for numerous diseases, including type 2 diabetes, cardiovascular disease and some cancers.[1,2] In Australia, the prevalence of overweight and obesity has been increasing; 63% of adults were classed as overweight or obese in 2014-­ 15, up from 57% in 1995.3 The Australian National Health and Medical Research Council (NHMRC) clinical practice guidelines for the management of overweight and obesity identify primary care as playing an important role in weight management,[4] and Health Expectations. 2021;00:1–9. | wileyonlinelibrary.com/journal/hex 1|2 there are increasing calls for primary care to screen for overweight and obesity.[5]initiating weight management conversations in primary care is a controversial issue for general practitioners (GPs)

  • Initiating weight management conversations in primary care is a controversial issue for general practitioners (GPs)

  • Identified barriers include insufficient time, concerns about upsetting patients, lack of training/confidence in this clinical area and perceptions that effective interventions are lacking.7-­9 A recent systematic review and thematic synthesis of 29 qualitative studies exploring GPs' and nurses' perspectives on discussing weight with patients with overweight and obesity in primary care highlighted that discussing weight is not perceived to be a priority for GPs.[10]

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Summary

A Community Jury on initiating weight management conversations in primary care

Scott PhD2 | Rebecca Sims MPsych (Clin)2 | Gina Cleo PhD2 | Helen Clifford MPH3 | Paul Glasziou PhD2 | Rae Thomas PhD2.

| INTRODUCTION
| Participants & recruitment
| Procedure
Findings
| DISCUSSION
Full Text
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