| PCP role in patient weight management |
I have a responsibility to make them aware that (their weight) is an issue where it’s clearly impacting on their (health). Do I have a responsibility to assist them with that? If they are looking for that assistance. I would have a responsibility to assist them or signpost them to what can assist them’. (GP 11; male; BMI 26.2) I don’t want to be weighing people every week. I don’t think that’s my role.(…)I think it’s also not a good use of our expertise as generalist doctors. I think we’ve got other things that we could be doing. (GP 6; female; BMI 23.3) Patients need to take some responsibility themselves. And if they know that they're carrying a bit of extra weight, they don't need to see a GP necessarily. (GP 12; female; BMI 24.7) We do have patients referred from the GP with bigger (weight) problems. I think perhaps they say, well that's that problem solved. Whereas(…)we've probably made it worse for that person because(…)we're not offering a solution. (PN 2; female; BMI 29.9) |
| Discussing weight issues with patients |
So, I have to say that I tend only to (raise weight for discussion) if I see it as relevant to the problem that they've got. (GP 1; male; BMI 26.2) I can legitimise that conversation (about weight) because I’ve got evidence here in front of me that helps me with that discussion. (GP 6; female; BMI 23.3) It’s when (patients) don’t present (weight) as a problem, and clearly, to my mind, it is a gross, elephant in the room, problem. And they don’t even want to even pick it up. Then I have a problem. Because it is an invitation for a dysfunctional consultation. (GP 5; male; BMI 23.4) To raise (weight for discussion) completely out of the blue, just because it's on the doctor's agenda, the patient hasn't even invited you to talk about that, what may be a very sensitive aspect of their self-image. I find, I would say, naturally difficult as a human being. (GP 11; male; BMI 26.2) |
| Barriers to weight management |
The biggest (weight management barrier) is the lack of any good intervention. Say if someone has high blood pressure, I can give them tablets that will bring it down (or) can give them an injection and make them better. If someone's got obesity, I'm kind of stuck. I can give them advice on what to do but I don't feel in many cases, that's terribly helpful or terribly effective. (GP 1; male; BMI 26.2) Someone with a BMI of 36, won’t be referred to a dietician because it’s not enough. So, we've got to allow a problem to become bigger before they get more specialised care. (PN 2; female; BMI 29.9) (Patients’)obesity feeds into (their other health issues), but actually whether or not I do anything about the obesity makes no difference to whether I've fulfilled my contract, which I've signed with the health board. (GP 8; male; BMI 25.5) (Patients’) can be helped with (weight issues) if they want to be or they can probably get there themselves with time and a bit of patience. But I think it is extremely difficult for people who find themselves in poor housing, they've got limited money, they perhaps feel that they have very little that is going to change or improve in their lives.(…)You're saying to them, well you could be a few pounds lighter and they’re thinking, well actually, I could be less suicidal. (GP 8; male; BMI 25.5) I don't feel I'm particularly badly trained in (weight management), but obviously what I'm asking them to do isn't working. Maybe the way I'm presenting it. I don't think what I'm saying is wrong.(…)It's maybe the way I present it to them, it's not ticking the right box and motivating them. (GP 2; female; BMI 22.6) |
