Overweight doctors pay little attention to obesity
General practitioners feel responsibility towards the prevention and treatment of overweight. In spite of this, many GPs - especially younger ones - only intervene when overweight in their patients has developed into obesity. And GPs who are themselves overweight or obese are less likely to refer their overweight patients for dietary advice. According to an article by researchers from the Netherlands Institute for Health Services Research (NIVEL) and VU University Amsterdam, published in the scientific journal BMC Obesity, overweight doctors pay little attention to obesity.
According to the World Health Organisation, overweight is a problem all over the world. Over the past few years, the number of people who are overweight has grown rapidly. In 2008 more than one third of the world’s population was overweight and 12% were obese. In the Netherlands, the percentage of people who were overweight increased from 28.2% in 1981 to 36.8% in 2011. The number of people with obesity doubled in the same period from 5.3% to 11.4%. If we do nothing about this problem, by 2024 two-thirds of the population will be overweight and consequently at higher risk of developing diabetes, cardiovascular diseases, cancer and arthrosis.
Prevention
The degree of overweight a person has is measured by the Body-mass index (BMI) which is calculated by dividing a person’s weight by the square of his or her height. A healthy BMI is between 18.5 and 25. If a person’s BMI is between 25 and 30 then they are overweight and above 30 is severe overweight or obesity. The majority of general practitioners (82.9%) consider prevention, discussion and treatment of overweight as one of their tasks. General practitioners who think of this as an important part of their work, address this issue seriously. However, most GPs only intervene when a patient is already obese and the stage for prevention is long past. Whilst this does not exactly go against the recommendations, it is still easier to prevent obesity than it is to treat it. Approximately half of patients with obesity are referred to nutrition specialists for dietary advice.
Role model
GPs under the age of 48 are less likely than their older colleagues to talk to their heavier patients about weight issues. And GPs who have regular contact with a nutritionist refer their patients more often for dietary advice. It was not a complete surprise to find out that GPs who are themselves overweight are less likely to refer their patients to a nutrition specialist. “An overweight GP is, of course, much less likely to function as a role model for his patients,” explains NIVEL researcher Cindy Veenhof. “It’s possible, for example that these GPs do not believe in the effects of a diet.”
Motivation
There is then room for improvement in the prevention and treatment of obesity in general practice. Before this can be achieved, however, a number of issues must be addressed. The first concerns time. GPs have only ten minutes consultation time for each patient and have indicated that this is too little to cover the subject of overweight with patients. But, effective weight loss can prevent patients from developing chronic conditions or at least delay their onset. So, in the long term, time would be saved. Another issue is that of motivation. Many patients are not motivated enough to lose weight. “It is therefore important to do something about patients’ motivation. GPs don’t have to do this themselves. Practice nurses and nutritionists can take on this task,” says Cindy Veenhof. According to the GPs who were interviewed, this doesn’t have anything to do with the costs of a nutritionist as everybody is entitled to three hours treatment under the standard health insurance package.
About 300 general practitioners took part in the study and completed a questionnaire.
Funding
Ministry of Health, Welfare and Sport
Cooperating partner
VU University Amsterdam