Glasgow Herald  May 14^th 2007 [Colin Waine]

 

This groundbreaking NHS weight loss programme now in use in some of Scotland's most deprived communities in Lanarkshire, Lothian and Tayside - as well as some communities in England - has helped obese patients lose weight and saved the NHS cash, research has revealed.  The news follows demands from Scottish GPs that lifestyle issues such as obesity are removed from their incentive pay scheme.

Members of the British Medical Association (BMA) said they should not have pay-related targets on obesity because there is no evidence they can do anything about it.  However, Counterweight has continued to report positive results. Through the scheme patients have regular one-to-one meetings with a diet expert who helps them adjust their eating and exercise habits.

 

NHS Lanarkshire, which was involved in the first trials, has introduced another 400 people to the programme since October. Evidence to date suggests it will be as successful as the pilot when 40% of those who completed it lost 5% of their body weight in a year. Marney Quinn, specialist obesity dietician for Counterweight in Lanarkshire, said: "Although the health economic outcomes are not published, it is very cost effective. We know that the person who is clinically obese attends their GP and their practice nurse more often and takes more prescriptions. If you address their obesity, the number of appointments with GPs and practice nurses all reduces."

 

Data showing the economic benefits of Counterweight has been passed to NICE.  Professor Iain Broom, chairman of Counterweight and researcher at Robert Gordon University in Aberdeen, said: "There is an argument that in the longer term it is cheaper to start doing something with patients who are willing to take part. It is very important that it is only patients who are willing to tackle the problem."

 

Colin Waine said not tackling obesity would mean rising bills for the health service.  He said: "If you can get people to lose 5-10% body weight, that is likely to be repaid in the long term. Being obese can reduce life expectancy by nine years.  It makes people far more likely to develop diabetes, heart disease, stroke, osteoarthritis, high blood pressure, gallstones, infertility and depression. Combined with lack of exercise, it contributes to one-third of cancers of the colon, breast, kidney and stomach. ¬ì

 

Dr Dean Marshall, chairman of the BMA's Scottish General Practitioners Committee, said doctors would discuss weight issues with patients. However, he added that obesity should not be in the Quality and Outcomes Framework (QOF) performance part of their contract until there was clear evidence they could make a difference.  Currently QOF rewards surgeries only for holding a register of patients with a body mass index (BMI) in excess of 30.

 

Professor Phil Hanlon, public health expert at Glasgow University, also said there was no proof that family doctors can help patients to lose the pounds and keep them off. Even though the Counterweight pilot found around 40% of participants cut their weight by more than 5% in the first year, researchers are yet to report on its long-term impact. "The idea that obesity is a clinical problem that GPs have an effective intervention for isn't well evidenced," he said. But he warned doctors were increasingly seeing people with medical problems linked to fat and they should strive to make a difference. "For a community dealing with the consequences of obesity not to want to be energetic about it, well if there is not a good way of doing it, let's find a good way of doing it," he said.