Holistic patient care key for overweight and obesity

In partnership with the RACGP, a new St Vincent’s Health Australia initiative is aiming to help GPs respond to what has been labelled a national epidemic – obesity.
 
St Vincent’s is encouraging GPs to prioritise conversations with their patients that explore obesity, to support them to make meaningful changes to their health.
 
The obesity, bariatric surgery and metabolic health GP education series is an RACGP CPD-approved activity, with GPs earning 1.5 CPD hours per session.
 
Developed by a panel of specialists, including Chair of RACGP Specific Interests Obesity Management, GP and dietitian Dr Terri-Lynne South, the education aligns with recommendations from the latest edition of Australia’s gold standard preventive health guidelines, the Red Book.
 
The newly launched 10th edition Red Book includes a chapter encouraging GPs to think holistically about their patients who are overweight and obese and experience barriers to healthcare access, discrimination and stigma.
 
In addition, the metabolic medicine chapter has been updated to emphasise it as an important health prevention activity and provides strategies for GPs in preventing chronic disease by addressing nutrition, obesity and physical activity with patients.
 
According to Dr South, the bariatric medicine series will help to improve GPs’ confidence and knowledge in this often-sensitive area of healthcare.
 
‘It is increasingly complex and challenging for GPs to have the weight loss discussion with many patients,’ she said.
 
‘How do you bring up the conversation with a patient about their weight, respectfully without creating stigma and shame and have a productive discussion around how their weight is probably affecting their health?
 
‘And to raise it in a safe environment when people are more sensitive than they used to be. It’s getting more difficult for GPs – especially with the “body positivity” social movement gaining a lot of publicity and momentum.’
 
Dr South says it’s ‘never been more confusing’ for people who are overweight or obese to navigate their health, with an overwhelming amount of weight loss and dietary advice, particularly across social media.
 
‘Most patients who come and see me have already tried many things, including a variety of diets, only to see their weight yo-yo up and down and unfortunately, most end up where they started or even carrying more weight over the years,’ she said.
 
‘It’s rare that a patient comes to me to talk about weight loss, where they haven’t tried a number of things or that they say they’ve done nothing about it over the years.
 
‘But it’s not a short consultation for GPs – especially if they’re trying to canvas various other health issues that might be related.’
 
The GP educational series comes as St Vincent’s describes obesity as ‘one of the greatest health crises of the modern era’.
 
In 2022, two in three (66%) of Australian adults aged 18 and over and one in four (26%) of young people aged 2–17 were living with overweight or obesity.
 
Australia also ranked 10th out of 21 OECD countries for the proportion of people aged 15 and over living with overweight or obesity, with this proportion greater than the OECD average of 59%.
 
Dr George Hopkins is a bariatric surgeon at St Vincent’s Private Hospital Northside and the Royal Brisbane and Women’s Hospital, who is also involved in development of the new education series.
 
He said the type of surgery depends on the health profile of the patient, and with recently updated international bariatric surgery guidelines changing BMI eligibility for the surgery, it has become more accessible.
 
‘[These changes have] shifted everything to the left to make things a little bit more accessible to people who are not diabolically sick and drastically overweight but who have for years had trouble losing substantial amounts of weight and keeping it off,’ Dr Hopkins said.
 
‘But the second part of it is that the evidence suggests in the last decade the surgery has got so safe that it’s now reasonable to offer it to people with the lower BMI, which is one of the reasons for the change.’
 
In Australia, a recommendation has been put forward to expand access to bariatric surgery within the public system as part of a recent Parliamentary report on diabetes.
 
Dr Hopkins, however, highlights that the surgery is ‘just the beginning’ and ongoing, holistic and preventive care with healthcare professionals to support these patients is essential.
 
‘For anyone considering weight loss surgery … they need to be prepared to make lifestyle changes and especially change their relationship with food and exercise,’ he said.
 
The Brisbane obesity and bariatric surgery symposia is a series of five free educational forums held throughout this year for GPs, which are expected to be available on-demand nationally by the end of the year. GPs can register for the sessions online.
 
RACGP resources

• gplearning is offering two online modules for GPs wanting to upskill in overweight and obesity, each eligible for 0.5 CPD EA hours: 

            – Bariatric medicine course

            – Practical management of childhood obesity 

• RACGP members can also join the Specific Interests Obesity Management group
• Healthy Habits program is a tool GPs can use to engage patients in lifestyle behaviour change

bariatric surgery CPD GP–patient relationship metabolic medicine overweight and obesity preventive health Red Book