Tackling obesity by offering the opportunity to attend a weight loss program during a routine consultation is effective, welcomed by patients and takes 30 seconds of physicians’ time, according to a new randomised trial of over 1800 people published in The Lancet.
The findings should provide reassurance to doctors who rarely talk to patients about their weight for fear of causing offence, lack of time or belief that such interventions are ineffective, the authors say.
They suggest the intervention should be considered as the first point of call for GPs in treating obesity.
The trial, led by the University of Oxford, included 137 GPs in England and 1882 people attending a consultation unrelated to weight loss.
At the end of the consultation, participants were randomly allocated to receive one of two 30-second interventions. Half (referral group, 940) were offered a 12-week weight management program available for free on the NHS.
If the referral was accepted, the GP ensured the first appointment was made for the participant and offered follow up. The typical conversation with the GP began with “While you’re here, I just wanted to talk about your weight…”
The other half (control group, 942 people), were advised by their GP that losing weight would benefit their health. All participants were weighed at the first consultation, then at three months they were asked whether they had taken any action to manage their weight. They were weighed again at 12 months.
Over three-quarters (77%; 722/940) of those offered the intervention agreed to take part in the weight management program and 40% (379/940) attended.
The average weight at the start of the trial was approximately 105kg for men, and 93kg for women. People in the referral group lost on average 1.43kg more weight than those in the control group (2.43kg average weight loss in the referral group, compared to 1.04kg in the control group). Furthermore, a quarter of participants in the referral group had lost at least 5% of their body weight after a year, and 12% had lost at least 10% – double the rate of the control group (table 4).
The majority of people (81%, 1530/1882) across both groups found the intervention appropriate and helpful, while only 4/1882 (0.2%) found it inappropriate and unhelpful.
Over the 12 months of the trial, a similar proportion of people in both groups had taken some action to lose weight, but approximately five times more people in the referral group had taken effective action.
Guidelines recommend that physicians screen for obesity and offer referral to weight loss programs, but in reality doctors rarely intervene because of a lack of time, fear of causing offence or a belief that the intervention would be ineffective, the authors say.
“Our study found that a brief, 30 second conversation, followed by help booking the first appointment onto a community weight loss program, leads to weight loss and is welcomed by patients” says Professor Paul Aveyard, lead author, University of Oxford who is also a practising GP.
The research team excluded people who were already taking part in weight loss programs.
They say the results are likely generalisable to other countries where similar weight loss programs are offered free of charge, including Australia.