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Doctors should not blame patients for being fat, according to new NHS guidance.It urges GPs to be more sensitive when dealing with obese patients, using a ‘respectful’ and non-judgmental tone.
The approach is designed to ‘minimise harm’, according to the National Institute for Health and Care Excellence.
The National Institute for Health and Care Excellence is urging GPs to be more sensitive when dealing with obese patients, using a ‘respectful’ and non-judgmental tone
With Britain in the grip of an obesity epidemic costing the NHS £5billion a year, NICE calls on doctors, GPs and other health workers, as well as those who run lifestyle weight-loss programmes, to monitor their tone and not add to the ‘stigma’ of being fat.
Only people with a body mass index (BMI) under 35 – the marker at which people are considered morbidly obese – should have their waist measured. Surgeries, meanwhile, should be adapted to provide out-size equipment for larger patients.
Last year it emerged that several NHS Trusts are refusing to give certain treatments to fat patients unless they lose weight.
Patients have been denied procedures such as hip and knee replacements and IVF, unless they agree to make radical changes to their lifestyle
Patients have been denied procedures such as hip and knee replacements and IVF, unless they agree to make radical changes to their lifestyle.
The NICE guidance also provides instructions for Public Health England, which is responsible for health campaigns.
It says it should ‘be aware of the effort needed to lose weight and avoid further weight gain and the stigma adults who are overweight or obese may feel or experience’.
It adds: ‘Ensure the tone and content of all communications or dialogue is respectful and non-blaming. The terminology used to describe the person’s condition should respect individual preferences.’
GPs and those running weight management programmes for the NHS should ensure patients have a realistic view of what to expect when losing weight, telling them there is no ‘magic bullet’.
Instead, obese patients should be advised of the importance of making gradual, long-term changes to their eating habits and physical activity and how much weight they might realistically expect to lose.
The latest draft guidance is being issued for consultation and will be finalised next May. Tam Fry, of the National Obesity Forum, said patients were often in denial and GPs should be sensitive – to start off with.
He said: ‘One of the big problems we have is that primary care – GPs in particular – have no real training about how to raise weight issues with patients.
‘The abrupt style that many have taken so far have only made matters worse.
‘NICE is correct to say they should be moderate in their tone. But once they’ve got the tone right and the confidence of the patient, they should really think about tough love.
'It’s essential that patients realise that the consequences of putting on weight are very serious.’
Professor Mike Kelly, director of the centre for public health at NICE, said: ‘Being overweight or obese can have serious consequences for an individual’s health, not only physically with increased risk of high blood pressure and type 2 diabetes, but it can also affect their mental health as a result of stigma and bullying or discrimination.
Tough love: GPs and those running weight management programmes for the NHS should ensure patients have a realistic view of what to expect when losing weight
'Levels of obesity in England are rising, with a little over a quarter of adults classified as obese and a further 41 per cent of men and 33 per cent of women overweight. This is a huge proportion of our population.
‘This new draft guidance focuses on the provision of effective lifestyle weight management services and makes a number of recommendations to ensure that the providers of programmes, whether from the private, public, or voluntary sector, follow good, evidence-based practice.’
A British Heart Foundation spokesman added: ‘Taking control of your weight can be a daunting task because changing the habits of a lifetime is often a challenge. That’s why it’s a good idea to get support throughout your weight-loss journey.
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