Weighty issue for GPs

Engaging in conversation with an overweight or obese patient about this aspect of their health can be intimidating for any GP…

The WA Primary Health Alliance (WAPHA) has announced the launch of SHAPE (Supporting holistic and person-centred weight education), a new online resource hub supporting health professionals to play a more central role in helping people to manage their weight.

SHAPE is a centralised website of tools, resources, and education, designed to support a better understanding of the complexity of factors influencing body shape and size, and how to engage patients and guide them on their journey.

WAPHA’s General Manager, Ms Bernadette Kenny, explained that equipping doctors to have that conversation with their patients to empower behavioural change is essential for supporting people who are overweight or living with obesity.

“Australia has one of the highest rates of obesity in the world, with about two thirds of adults and a quarter of children in Australia considered overweight or obese,” Ms Kenny said.

“We have an important opportunity to change this through equipping health professionals with the skills and confidence to start the conversation with those who are seeking guidance to improve their health.

“Conversations about weight can be sensitive and are often challenging for both health professionals and patients alike, and a reluctance among health professionals to discuss weight, along with stigma, shame and other psychological factors often act as barriers to people seeking or getting the support they need.”

SHAPE offers Conversations about Weight and a suite of training modules for health professionals which have been developed by Diabetes WA and are accredited by the RACGP.

The training focuses on different aspects of weight management, including causes and treatments, from the perspective of both patient and health professional, and each module provides insight into the complexity of this topic.

Ms Kenny said that the project’s Clinical Content Working Group (CCWG) made a significant contribution throughout development of the hub, providing direction, advice, and clinical expertise along the way.

CCWG member, Dr Rebecca Hunt-Davies, explained that GPs engaging in these conversations often had a fear of offending or upsetting patients and damaging the doctor patient relationship; and could experience difficulty in determining patients’ readiness to look at weight related issues – the patient may not view their weight as a health priority.

“Parents of children may be particularly sensitive to children’s weight being raised and so therefore this is often a barrier because doctors do not wish to offend the parents or upset them,” Dr Hunt-Davies said.

“Similarly, when patients have multiple medical issues, and they are trying to grapple with those issues, then raising weight related issues can be tricky because their priorities may be different to that of the practitioners.

“I do not think that patients that are overweight should be considered unhealthy just purely because they are overweight, but medical professionals do have responsibility to advise their patients that weight loss is part of their treatment for those medical conditions that benefit from doing so,” she pointed out.

“Weight loss can be very beneficial for a range of health conditions which can lead to the patients feeling better in themselves and leading a more functional and fulfilling life. This does not mean that they will necessarily no longer be overweight however they may feel happier and healthier and able to do more things.”

She estimated that at least one third to half of her patients’ general health issues would benefit from addressing their excess weight, but that was not usually the reason they attended for a GP appointment.

“It probably gets mentioned to them once or twice a year in general advice following blood test results or routine measurements but until they are ready to engage in the process then it often doesn’t get addressed in detail,” Dr Hunt-Davies said.

“Social media and talk amongst friends were the most common threads in more recent times as the reason that patients have booked a weight specific consultation with me.”