Fletcher and Patrick1 make an excellent case for population-level measures to curb obesity rates, but fail to highlight opportunities for improvement in primary care and medical education.2,3
In the average family practice, about 4.4 hours per day would be required to provide only A-level preventive screening to adults over 25 years of age.4 It is not surprising then that only 23% of obese individuals have a documented care plan.5
Innovative tools exist to make obesity prevention quicker, easier and more effective. Simply adding a signed prescription with clear instructions can increase patient adherence to exercise and diet advice.6
Modifications to physician education are also required. Most medical curricula in Canada do not offer formal education in obesity prevention.1 Canadian medical graduates report dissatisfaction with current nutrition education and their ability to provide nutrition counselling to patients.7 To that end, an enhanced medical education curriculum is being developed and piloted in Canada.2
The past 50 years of battling Big Tobacco has shown that physicians can offer leadership in both clinical innovation and healthy public policy8,9
We are proposing a multilevel approach to obesity prevention, integrating physicians with allied health, public health and community incentives. This is the foundation of our multiclinic pilot study, Prevention Rx, which is currently under evaluation.
Letters to the editor.
Letters have been abbreviated for print. See www.cmaj.ca for full versions and competing interests.
References
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