A Survey of Health Professional Attitudes to Body Weight Status

• Project start date: 1 August 2010
• Project status: Completed
• Project type: Nutrition
• Discipline: Obesity
• Author/s: Dr Anne Moorhead, University of Ulster, Jordanstown
• Collaborator/s: Single supplier

Research objective

• To assess attitudes, current practices and knowledge of body weight status among primary care health professionals.
• To assess primary care health professionals’ ability to identify body weight categories in both adults and children.

Outputs

Research report

• Title: Weight Management in Primary Care
• Publication date: 5 May 2013
• Summary: Current attitudes and skills of primary care health professionals towards weight management with recommendations on how to support them in identifying, treating and managing the challenge of overweight and obesity.
• Findings:

  Primary health care professionals generally have a positive attitude towards their role in preventing and managing overweight in their patients, in contrast to more negative attitudes found in research from the UK, US and Australia. However, participants identified significant barriers such as lack of training and confidence, and time constraints. They saw overweight and obesity as a very complex issue, with inconsistent media messages adding to the challenges. Lifestyle interventions were favoured over drugs and surgery for overweight management.

  Factors influencing professionals’ attitudes and practices include their own weight status, their age and duration in practice and also by the healthcare system in which they practiced. While they showed positive and empathic attitudes to overweight patients, professionals with more clinical experience were better at assessing patients’ weight but less optimistic about the outlook for overweight patients. Health professionals are understandably affected by society’s norms and with the growing obesity epidemic they have difficulties in assessing and addressing issues of overweight in their patients.

  The research participants reported low confidence in managing overweight, particularly in children. The professionals working in ROI reported less training and having fewer resources than their counterparts in NI, although both the HSE and PHA have appropriate guidelines and algorithms in place. Despite recognising their role in managing weight issues, there was a strong call for more on-going training and support.

  There were some interesting findings from the use of the online tool for assessing body weight status in a range of adult and child models. When the models wore a standardised uniform of T-shirt and shorts, professionals were more accurate at deciphering weight status. However, in real practice, with patients wearing their own clothes, these visual assessments were far from reliable. This underlines the importance of objective resources with the use of a tape measure and weighing scales. However, this simulation tool may be of value in training exercises.
• Recommendations:
  1. A programme of training for primary health care professionals on weight issues should be implemented on the island of Ireland (specific to the professional support and dealing with both adult and child populations).
  2. On-going support should be provided towards the implementation of the relevant NICE guidelines and the HSE weight management algorithm.
  3. Guidance on how to approach the topic of overweight with patients should be provided.
  4. Referral options should be available for patients, as appropriate (dieticians, physical activity specialists, psychologists and endocrinologists).
  5. Measuring patient’s weight, height and waist circumference should become routine in primary care consultations.
  6. Lifelong weight awareness and discussion should be standard practice.
  7. Objective measurements of weight status should be the norm.
  8. Clear and consistent messaging on weight and health issues should be realised by a co-ordinated responsible effort of public and voluntary agencies, together with the media.

Other outputs

Moorhead SA, Coates V, Hazlett D, Gallagher A, Murphy K, Nolan G, Dinsmore J. “Weight Care Project: Health professionals' attitudes and ability to assess body weight status” - Study protocol. BMC Public Health 2011, 11:202.

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