Changing the prevalence of obesity one consultation at a time.

We are pleased to invite you to:

The Institute of Health and Wellbeing Maurice Bloch Annual Lecture Series 2016/17

Title: Changing the prevalence of obesity one consultation at a time. A randomised trial of screening for and brief intervention upon obesity.

Presenter: Professor Paul Aveyard

Date: Thursday 12 January 2017

Time: 1.00pm a light lunch will be served 30mins beforehand

Venue: TBC

Chair: Professor Sharon Simpson

Abstract:

There is suggestive evidence that GPs can motivate people to lose weight but they rarely try to do this. They worry that doing so will cause offence, take a long time, and is unlikely to work anyway. In the first trial of its kind, we tested whether it is effective and acceptable for GPs to screen for obesity and offer a very brief intervention opportunistically. Patients consulting 137 primary care physicians in England were screened. At the end of the consultation, the physician randomized participants to one of two 30-second interventions. In the active intervention, the physician offered referral to a weight management group, if accepted they ensured the patient made an appointment, and offered follow-up. In the control intervention, the physician advised the patient their health would benefit from weight loss. Participants rated the appropriateness and helpfulness of the physician’s intervention. The primary outcome was weight change at 12 months. 8403 patients were screened; 2728 (32%) were obese. Of these, 83% agreed to participate. We excluded people already or recently taking action on their weight and 1882 were eligible and enrolled. In this presentation I will report on patients’ initial reactions to the GPs intervention and flesh these out with findings from interviews with 31 people. We will report how many people took action and the impact on their weight at 12 months in both groups. I will also draw on conversation analysis of consultation recordings to give preliminary insights into what makes interventions more and less effective. Finally, modelling of UK data suggests that, on current trends, the prevalence of obesity will be 31% by 2035. We have examined the impact on prevalence, health service costs, and QALYs if GPs used the brief intervention just once a year in every person with a BMI of at least 30. The results suggest a surprisingly large effect, which I will describe.

Biography

Paul Aveyard is a practising GP, public health doctor, and a professor of behavioural medicine at the University of Oxford. Throughout most of his career, his research has been in tobacco control, particularly developing and testing interventions to promote smoking cessation and harm reduction, testing these in large trials. Over the past few years, he has also developed a programme of research on obesity management for clinicians without a special interest in the topic. His programme seeks to apply the methods used in smoking cessation to the field of weight control, where there are many parallels.