How can a GP help with weight loss?

[razed]

Hello everyone!

Aside from trying to reduce calories and increase activity, how else can a GP help patients to lose weight? On the news, for example, the government said that they would encourage GPs to ‘prescribe’ cycling to overweight people.

Does anyone have any experience of ideas of how a GP can help?

Many thanks

[N-o-r-d-i Maintainer 64kg]

My experience:

measured blood pressure, sent for a blood check, which said “borderline under-active thyroid, recheck in a few months’;

sent for a 12 week activity programme (free exercise groups twice a week for people with health issues, following which they were giving a reduction on gym membership, but you could no longer attend the same activities and I felt too self-conscious to go to regular exercise class even for a reduced price)

prescribed Orlistat, which I don’t think made any difference apart from making stools oily 😊

Referred to a dietitian (which was a few appointments spaced over a couple of years and practically useless, if I’m honest).

Referred for a CBT (for which I had to wait over a year).

All in all... I’d think, at least for me, this forum seems more helpful, unless there are some serious underlying health concerns.

[SofaJockey]

There may well be GPs who are excellent.

My own GPs and two Consultant Specialists were next to useless. They were too focused in giving me more drugs and treatments, despite my requests (which given my eventual weight-loss I no longer needed).

If you like cycling, you don't need a prescription to do it.

If you want to lose weight, you don't need a Doctor's permission *

(* though they should be aware of your plans if it has medical impact on your current treatment or medication)

I'm not convinced 'reduce calories and increase activity' is necessarily the best starting point as not all calories are the same. It's well worth taking a look at what to eat, rather than just a calorific value.

This is an excellent leaflet that is a good starting point for many: 😊

phcuk.org/wp-content/upload...

[Chappychap Visitor]

"Aside from trying to reduce calories and increase activity, how else can a GP help?"

Maybe reducing calories or increasing activity won't actually help as much as you think?

In the 1970's only about 2% of the UK population were obese, today it's about 30% (with another 30% overweight). So what was different comparing the 1970's to today?

There are lots of theories but one key fact is that it's not calories. The average person today eats pretty much the same calories that they were eating then (in fact in the UK we're eating very slightly fewer calories, and in the USA they're eating very slightly more calories, but in neither country is the difference all that significant).

So is the explanation "increasing activity"?

Tempting to think so. But the people today doing harder manual jobs, and the people today doing jobs that mean they're on their feet all day long, well they're actually the people who have the biggest obesity problem.

There are many, many different and competing theories as to why the 1970's and today are so different. But one hard fact worth reflecting on is this.

In the 190's there wasn't a culture of constant grazing and snacking between meals. There wasn't the infrastructure providing easy access to snacks, and there wasn't the general acceptance. Indeed there was a culture of "not spoiling your appetite" that actively suppressed eating between meals. Most people ate three meals a day (a surprisingly large percentage only ate twice a day), they sat down to eat, and they ate with a knife and fork. Today we average about six "eating occasions" per day, often while on the move and using our fingers.

[Hidden in reply to Chappychap]

I've said the same thing many times Chappychap !

[slipstick Maintainer 2st 7lbs]

I'm not sure what they're like now but a few years ago my GP gave me a 12 week free pass to Slimming World. SW is generally not liked round here but is slightly more than just "reduce calories" and it started me on a path that led to me losing over 3 stone and (mostly) keeping it off. That and 3 month free passes to the local leisure centre used to be available but I don't know if they still are with all the cuts and what's going on with covid19.

But the pattern is very varied across the UK and unfortunately most GPs have little if any formal training in nutrition or weight loss so it's really down to if your particular GP has an interest in those areas.

[TheAwfulToad Visitor]

First off, they can stop telling people to reduce calories and increase activity. As several other people have noted above, it's completely counterproductive; the usual result is that it makes people miserable, and fatter than ever.

Frankly, I don't think GPs are the right people to advise people on weight loss and good health. Their training is in pathology, and their default mode of thinking is to treat everything as a malfunction to be knocked down with drugs or some other drastic intervention. Stopping people getting ill in the first place - that is, the study of how healthy bodies work, and stay healthy - is not something they spend much time on in medical school.

[katieoxo60 Visitor]

Gps can do social prescribing i.e referrals to activity groups specifically for weight problems, pain, lungs, and emotional problems might be worth trying. Good luck Razed.

[IndigoBlue61]

Not the GP but the practice nurse got me onto our local health authority Weigh Loss initiative that I found really helpful, it just suited me. It was Dietician led, strictly portion control & advocated small, step by step, changes. She recommended we all look at the NHS 12 week plan for the weekly emails, which led me here.

This was 5 years ago next week. I realise this isn’t for everyone, and each GP practice will vary, but I had a positive experience. I’ve maintained an acceptable weight for over 4 years.

Indigo

Ps did you see my post yesterday about the new government initiative? healthunlocked.com/nhsweigh...