Researchers from King's College, London, have concluded that weight management efforts in primary care need to be better documented in electronic records in order to assist caregivers and patients at the individual level, and also to buttress public health efforts at reducing obesity.
Overall, the researchers found that weight management care given to even morbidly obese patients touched only about 40 percent of patients.
"It is possible that rates have been underestimated through a lack of formal recording in medical records," authors Helen Booth, A. Toby Prevost, and Martin Guilford wrote. "However, the growing burden of obesity on primary healthcare services and lack of long-term follow-up on the effectiveness of these treatments supports the use of structured recording of interventions for weight management and subsequent follow-up. This is particularly true given the heterogeneity of results from weight loss studies included in reviews of the effectiveness of primary care interventions for obesity and the need for further evidence specific to patient subgroups, for example, those with comorbidities."
The study, published in BMJ Open, followed 91,400 patients whose electronic records were in the United Kingdom's Clinical Practice Research Datalink who were diagnosed as overweight or in three classes of obesity. The authors found that overall spotty weight management practices may be due to several factors, including poor documentation or lack of access to weight management interventions "due to a lack of clinician awareness or confidence in treating obesity," and that guidelines on the management of obesity from the National Institute for Health and Care Excellence do not appear to have been successfully implemented into practice.
The researchers also concluded similar patterns of care have emerged in U.S.-based providers' weight management regimens.
"A decline in lifestyle advice and counseling for weight loss given to obese patients over the past 10 years has been also been reported in studies from the USA," they wrote. "Reasons behind this reduction, despite increasing obesity levels, include poor recording of advice, lack of time in consultations, pessimism regarding potential success of weight loss attempts and increased use of medications to treat obesity-related risk factors and disease, and, perhaps, normalization of excessive body weight."
The full study is available here.
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