Anthony Leeds: 'Have you stepped up to the obesity challenge?'
Nurses are in an ideal position to tackle the growing rate of obesity, says Anthony Leeds
A recent report from the Royal College of Physicians, Action on Obesity: Comprehensive Care for All, called on the government to “step up” to the obesity challenge and do more to ensure that the NHS provides better management for patients who are obese.
Obesity in the UK is among the highest in the world, exceeded only by the US and some countries in the Middle East. Early projections suggest that most people in Britain will be obese by 2050.
The report argues, however, that primary, acute care and specialist services remain underdeveloped or unavailable to meet the challenge, and there needs to be a much more joined-up approach between hospitals and community services.
Diet, lifestyle, drug and surgical interventions must all be evidence based and understood by health professionals, and the RCP report sets out the needs for education and the setting up of services in the UK.
“The report also highlights the importance of nurses in the overall provision of obesity care for all patients, and the need for education in this specialist field”
The report also highlights the importance of nurses in the overall provision of obesity care for all patients, and the need for education in this specialist field.
It suggests that the Royal College of Nursing should set up a specialist group of bariatric nurses. There are already many specialist bariatric nurses working in surgical units but many more are needed to spend time on non-surgical management.
Nurses as a group probably get more education on and have more experience of diet and lifestyle-related issues, and spend more of their time talking to patients about these issues than doctors. However, most would acknowledge that there is still a need for more focused nurse education reflecting increasing specialisation.
Most people who are overweight or obese will need to be helped in primary care so the role of the practice nurse is critical. Few patients - although as time progresses, the number will increase - will go forward for acute and tertiary care. Patients treated with bariatric surgery will be managed in primary care from two years after surgery so all practice nurses will need to run the annual screening for such patients and be aware of the features of complications and side-effects of surgery that sometimes occur.
The UK and, indeed, the world as a whole is in a strange place with respect to obesity. The condition is a global pandemic. Obesity is an underlying factor, among others, in several major conditions including diabetes, hypertension, heart disease, arthritis and some cancers, all of which cause serious morbidity, lower the quality of life and incur huge medical costs. Obesity is also responsible for huge public spending outside healthcare budgets, for example for absenteeism from work directly related to obesity.
Nurses are in a central position to: assess patients for obesity; raise the topic with patients; explain the hazards; motivate the patients into action; help with individual solutions; and break down the barriers to change.
Anthony Leeds is physician with a special interest in obesity at the Central Middlesex and Whittington Hospitals, London; visiting professor at the University of Copenhagen, Denmark; and medical director of Cambridge Weight Plan.
Take our Nursing Times Learning Unit on managing obesity: www.nursingtimes.net/obesity