The management of obesity in primary care: a pilot study

Abstract

Background: Obesity is recognized as a global public health issue, with prevalence in the UK increasing sharply during the 1990s and early 2000s. The National Institute for Health and Care Excellence (2006 ) recommends that ‘managers and health professionals in all primary care settings should ensure that preventing and managing obesity is a priority, at both strategic and delivery levels’. The aim of this study was to develop and evaluate a facilitated self-help weight-management intervention for obese adults attending general practice. Method: A two-phased study was used. Phase 1 developed a facilitated self-help weight-management intervention, and phase 2 delivered and evaluated the 6-month intervention using a pre- and post-test design. Semi-structured interviews and focus groups were used in phase 1. Measurements of height, weight and waist circumference were taken during phase 2. Nurse interviews and patient questionnaires were used to evaluate the quality and acceptability of the results obtained. Results: The intervention was successful in attaining statistically significant reductions in mean weight of 4.20 kg (95% CI 2.43, 5.97), in mean BMI of 1.52 kg/m2 (95% CI 0.88, 2.16) and in mean waist circumference of 4.66 cm (95% CI 2.38, 6.94) at post-intervention. Patients reported that they valued regular contact with the practice nurse, and that increased knowledge about healthy eating and the educational material provided had facilitated behavioural change. Practice nurses felt the intervention was easy to implement and relevant to primary care. The monthly supervision meetings were valuable and provided an opportunity for the nurses to reflect on practice and discuss new ideas. Conclusions: The intervention was effective and practice nurses attending a short training course followed by minimum supervision were able to successfully deliver the programme.