Implementation of NHMRC obesity guideline recommendations

Author: 
Mark Harris, Ian Caterson, Nigel Stocks, Elizabeth Denney-Wilson, Gary Wittert, Catherine Spooner
Publication type: 
Conference presentation
Program: 
Stream 3 Implementation of obesity guidelines in PHC
Year: 
2014

Presented at GP14 - The RACGP Conference for General Practice, 10 October 2014

Presentation slides are available here

Overview

Obesity is a major public health issue and in general is dealt with poorly, or not at all at many levels, within the health system.  It is very common in general practice (35% of attending adults are overweight and 27% were obese) and there is evidence that management in primary health care can be effective.

The recently released NHMRC obesity guidelines are intended for use by general practitioners, general practice nurses and allied health professionals and follow the primary care ‘5As’ framework: ask, assess, advise, assist and arrange.  The evidence underpinning this guideline is that a 5% initial weight loss does reduce the risk of chronic diseases such as diabetes and cardiovascular disease.

The key messages for the management of adults include: -

a) Measure and record waist circumference in addition to calculating BMI.

b) Discuss readiness to change lifestyle behaviours, set agreed goals and a self-management plan.

c) Refer those who do not achieve at least a 1% weight loss to other providers, programs or services.  Know when to consider more intensive low energy diets or surgery;

d) Use multidisciplinary approaches - these work better than single interventions; and

e) Prevent relapse and provide ongoing monitoring