GPs 'could do more' to help obese avoid surgery

Surgery to treat obesity could be avoided if GPs and healthcare trusts put more time and money into early stage weight management programmes, a senior clinical researcher will say today (Wednesday, 17 December, 2008).

And he will say that patients suffering from obesity face a "post code lottery" when seeking access to specialist care.

Speaking at the British Pharmacological Society's Winter Meeting in Brighton today, Dr Nick Finer, Clinical Director, Wellcome Clinical Research Facility at Addenbrooke's Hospital in Cambridge, will call for anti-obesity drugs to be more widely used.

Dr Finer will say that these drugs are cost-effective interventions and do work if correctly used.

But he will add that in some patients early potential for drug treatment to prevent the later need for surgery is being missed - due to the reluctance of primary care doctors to treat obesity.

In his presentation, entitled 'Clinical challenges: can current drugs compete with surgery?', Dr Finer will be discussing the place of drug treatment in the management of obesity.

Dr Finer said: "About one third of people taking the two drugs currently licensed for obesity management, in conjunction with a diet and lifestyle programme, will achieve a 10 per cent weight loss and around half a five per cent loss. Weight loss is well maintained if drug treatment is continued.

"Drug treatment has also been shown to delay or prevent the development of type 2 diabetes, reduce cardiovascular risk factors and improve well-being.

"These results clearly do not match surgery but could be more generally adopted in clinical care.

"Despite NICE (National Institute for Health and Clinical Excellence) guidelines, there is a reluctance of primary care doctors to treat obesity, with or without drugs, and thus the early potential for drug treatment to prevent the later need for surgery in some people is missed.

"There remains a strong antipathy from many doctors, primary care trusts and specialist commissioning groups to invest in obesity management.

"NICE guidelines - and even more seriously previous Health Technology Assessments - remain to be implemented. There is a complete post code lottery for patients to access specialist care.

"Until the QOF (Quality and Outcomes Framework) system remunerates GPs for undertaking weight management there will be little stimulus for adoption of current evidence-based treatment guidelines."

Dr Finer is just one of the presenters at a special symposium on Obesity at the BPS Winter Meeting, which also includes a presentation on the regulatory challenges for new anti-obesity drugs. For the full programme please see below.