Overweight and obesity

Transcription

1 Overweight and obesity How to raise the issue Rachel Clark Health Promotion Manager World Cancer Research Fund UK #canprevent

2 Rachel Clark Health Promotion Manager, WCRF UK Registered Public Health Nutritionist

3 Making every contact count

4 Barriers to raising the topic BMJ findings 1 : 1. Limited understanding about obesity care 2. Concern about negative consequences i.e. damaging their relationship 3. Having time and resources to raise a sensitive topic Practitioners worried about their own weight 1. Blackburn M et al. Raising the topic of weight in general practice: perspectives of GPs and primary care nurses. BMJ Open 2015;5:e doi: /bmjopen

5 1. Limited understanding about obesity care Skills how to raise the issue/how to support weight loss Knowledge of guidelines/resources Just bringing it up.. how do you bring it up, when they ve come in about a cold? It s really difficult isn t it because you know we ve all got to be very PC (politically correct) and people get very hurt even with medical terms like obesity or overweight, it can be really challenging.

6 1. Limited understanding about obesity care Compared to smoking and alcohol Support at primary care and national level Increased provision of services Greater acceptance as a health threat Established brief interventions and referrals

7 2. Concern about negative consequences Damage to patient relationship Ineffective at helping patient Fear of upsetting patient/feeling awkward Patient s receptiveness to advice Professional reputation Desire to remain non-judgmental

8 3. Having time and resources to raise a sensitive topic Competing goals within a consultation (especially GPs) Not having resources to then signpost people to Other priorities e.g. smoking That s the trouble isn t it, it s the conflict of time for all the other things that we re supposed to do in a ten minute consultation, of which probably smoking cessation comes quite high on the sort of health promotion thing and alcohol, of course, that s another.

9 Practitioners worried about own weight Both healthy weight and overweight practitioners identified their weight as a barrier Being a rather large person myself, I find it sometimes, a little bit sensitive to say, You really ought to lose some weight, when, actually, the same person could be saying it back to me.

10 Addressing the barriers Knowledge about obesity services and the health professionals role in management and prevention Training and education about engaging patients about weight in a non-stigmatising and non-harmful way Learning from successes e.g smoking Making weight management routine

11 How to raise the issue Think about the context Ask permission would you mind? Is it OK to.. Find out what the patient already knows Offer advice/information in a neutral way Ask for patient s reaction ( What do you think of that? ) Follow up let me know what you think?

12 Client centred Skills needed 2 Active Listening Skills Greeting/opening the interview Non-verbal communication Reflection (the key skills to demonstrate empathy) How we end the consultation 2. Moira Stewart. Patient Centred Medicine Transforming the Clinical Method. 2003

13 Avoid advice giving Why don t you... What about... Have you tried... If you could just... Use a smaller plate Take one bite at a time Chew slowly Use stairs instead of the lift

14 Example Part of my role is to look at lowering your risk of getting cancer in the future, would you mind if we discussed your weight and how it may affect your risk, for a couple of minutes? I am just wondering what you know about the longer term risks of cancer and a person s body weight? Lots of my patients have found this leaflet very useful to explain the link between bodyweight and cancer, would it be OK to look at this page with you? What did you make of that information? Was anything a surprise to you? You can take this away and read it in your own time, let me know what you think

15 Active listening Have you thought about cutting down on your snacking? Yes many times but I can t seem to manage. It s my one comfort, I m stuck in the house so much these days. It s not easy You can say that again! I think I eat because I m bored

16 Next steps Lack of interest Leave the door open Increase understanding of health risks Minimise further weight gain Record Interested Explore options available e.g. exercise referral/slimming group Signpost Take baseline data (if applicable) Record and revisit

17 Resources to help Online BMI calculator/waist measurement guidance Healthy recipes Alcohol calorie calculator Exercise calorie calculator Booklets and factsheets Diaries

18 Cancer Prevention Champions Help shape our work Be the first to hear about new projects Help us to spread the message

19 For further information Rachel Clark Health Professionals Programme Manager World Cancer Research Fund facebook.com/wcrfuk #canprevent