Doctors must treat obese patients with respect and be careful not to blame them for becoming overweight, new draft official NHS guidance says.
The National Institute for Health and Care Excellence (Nice) says obesityis a serious problem not only for individuals who risk type 2 diabetes, heart disease and some cancers, but also for the NHS, which is having to spend an estimated £5.1bn a year dealing with the consequences.
In draft guidance on services to help people manage their weight, which is now out to consultation, Nice says that quick fixes do not work. Programmes such as those run by WeightWatchers and Slimming World are not a magic bullet, it says.
People should be referred to programmes that not only offer to help people cut down on the calories, but also change their eating and exercise behaviour for the long term.
"This draft guidance isn't about quick fixes, it is about ensuring lifestyle weight management services support people in the long term," said Professor Mike Kelly, director of the centre for public health at Nice.
"Programmes that address diet, activity and behaviour change can help people who are obese lose weight but they are only cost-effective if the weight is kept off."
Kelly stressed the severity and scale of the problem.
"Being overweight or obese can have serious consequences for an individual's health, not only physically, with increased risk of high blood pressure and type 2 diabetes, but it can also affect their mental health as a result of stigma and bullying or discrimination.
"Levels of obesity in England are rising, with a little over a quarter of adults classified as obese and a further 41% of men and 33% of women overweight. This is a huge proportion of our population."
People should not be blamed for being fat but nor should they be misled about what they can expect from a weight management programme, Nice says.
GPs and those who run programmes should explain that none of them is a magic bullet – motivation and commitment are needed to lose weight and maintain the weight loss. People should be told how much – or how little – they can actually expect to lose, but also of the health benefits of losing even a small amount.
Nice recommends that GPs should focus mainly on adults with a BMI (body mass index) of more than 30 – but among black African, African-Caribbean and Asian groups, a lower threshold can be used.
