GPs on the front-line of Australia’s fight against obesity

By Learne Durrington

CEO, WA Primary Health Alliance

In my December 2017 CEO column, I wrote about WA Primary Health Alliance’s early steps to define our role in responding to the State’s escalating rates of adult and child overweight and obesity. We’ve made quite some progress since then and continue to work with State and Commonwealth partners to identify and agree our priorities in prevention, early intervention and management.

At the invitation of the Australian Government, we recently attended the National Obesity Summit to represent Australia’s 31 Primary Health Networks (PHNs). Our involvement was crucial to ensure that primary care is integral in the development of multi-faceted and community wide approaches to addressing overweight and obesity.

Latest ABS figures tell us that 67 per cent of Australian adults and 25 per cent of children aged five to 17 are overweight or obese – and these rates are increasing rapidly. There’s a lot of discussion at national and state level on obesity prevention, focussed on policy change in the form of sugar tax and advertising restrictions. Less of the discussion appears to be on early intervention and management – the space where GPs are front and centre of quality, evidence-based care.

Dr Georgia Rigas, Chair of the RACGP Obesity Management Special Interest Group, spoke at the Summit about the need for a primary care led response to addressing obesity as a chronic, progressive health condition. She stressed that advising someone with severe obesity to “eat less and exercise more” is an approach that’s akin to telling someone with depression to “cheer up”. We’ve come a long way in applying a scientific approach to recognising the complexity of depression, acknowledging that it’s not solely about will power and personal responsibility. We need to now reflect this in our response to obesity and weight management.

Dr Rigas, and other Summit speakers from academia and government, made the strong point that GPs are the front-line health professionals in Australia’s fight against obesity. With this comes a requisite responsibility for the College, the PHNs and others to provide the support GPs need to help people struggling with overweight and obesity to achieve their goals to improve their health, function and quality of life.

In a recent study published in the MJA, research showed that, nationally, only 22 per cent of general practice patients had their BMI documented and 4.3 per cent had their waist circumference documented. It is well recognised that instigating a conversation about weight management in a general practice setting can be challenging, particularly when the presenting condition is not specifically a patient’s weight. We know GPs are asking for a contemporary register of appropriate, quality assured and evidence-based weight management services and programs to refer patients into.

GPs with patients who have access to surgical interventions such as bariatric surgery (recognising the current four-year waitlist for eligible patients accessing public bariatric surgery in WA) report that providing good continuity of care depends on the GPs involvement in the pre and post-operative stages in the patient care journey. To enable general practice to respond effectively, there is a compelling case for collective action on the part of WA Primary Health Alliance and our WA partners to develop and provide the necessary resources, education and pathways.

WA Primary Health Alliance, with the WA Department of Health and Health Consumers Council of WA, is a partner in the State Obesity Collaborative which is tasked with developing WA’s Healthy Weight Action Plan. With our leadership, the Action Plan has a clear focus on early intervention and management of overweight and obesity in primary care. We all agree on the importance of resourcing GPs and their practice teams with education and clinical pathways for evidence-based treatment options and best practice advice in the early intervention and management of overweight and obese patients.

We are now working with key stakeholders to develop a quality and accreditation system for weight management programs and services and a central repository which referrers and the general public can easily access to inform their choice of effective, evidence-based interventions. We’re also focussing on developing resources, tools and education for GPs and their practice teams to leverage their unique position in talking to patients about weight management.

GPs have told us that a key first step in supporting their patients is to initiate the conversation based on well planned, very brief interventions that can increase the chances of a patient making a successful weight loss attempt. GPs don’t have to be clinical experts in weight management to be able to incorporate this into their routine consultations with patients who are overweight or obese – and they don’t need to spend a lot of time to make a difference.

Article by Learne Durrington – CEO WA Primary Health Alliance