With early deaths from obesity set to overtake those from smoking, a primary care service encouraging patients to address their weight is achieving measurable results
More than half the adults in the former Leeds North West primary care area are above ideal body weight, with 3,100 of them morbidly obese. The Choosing Healthwhite paper sets out the public health and clinical agenda for addressing obesity, nutrition and physical activity, those modifiable contributory factors to death expected to overtake smoking in their prevalence.
Leeds North West PCT invested in the development of a multidisciplinary primary care weight management service as part of its food, physical activity and obesity strategy.
Using a menu of weight management interventions the service supports primary care to help obese people lose weight and maintain weight loss while adopting healthier lifestyles. It also helps improve the efficiency of anti-obesity medications and identify people who require obesity surgery. Further work has developed an integrated approach through best practice guidelines, pathways on obesity management and partnerships with external organisations.
First phase project work began in 2003 with the introduction of 10 per cent clubs - weight loss groups taking place in GP practices. Patient surveys showed almost 40 per cent of patients using them had lost an average of 12.5 per cent of their body weight after six months. This level of weight loss has been shown to confer significant long-term health gain. The service gave evidence to the Commons health select committee inquiry into obesity in December 2003.
The project now employs a multidisciplinary team of community dietitians, physical activity advisors and a mental health worker delivering a range of weight management resources and training including one-to-one and group support. All GP practices in the area use the service.
Value for money is demonstrated with the reduction in prescribing costs of obesity medication. Before full implementation in 2004-05 there was an 18 per cent increase in the number of anti-obesity medications prescribed across the PCT. From December 2005 to February 2006 there was a 2 per cent decrease, a£14,000 saving that extrapolates to£56,000 over 12 months.
A community dietitian manages the project, working closely with a multidisciplinary group that oversees direction and compliance with modernisation strategies.
With reconfiguration in mind and the appointment of a new director of public health medicine pending, a task group met recently to examine how Leeds might introduce a city-wide strategy. One idea is to train more health professionals or community workers as physical activity advisors to deliver 10 per cent clubs while specialists provide detailed guidance on medications and surgery.