European GPs don't know how to deal with obesity epidemic
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《英国医生杂志》
European GPs know that they are facing an obesity epidemic but do not know what to do about it, a debate on obesity heard last week. "European trends in obesity are now in parallel with the United States," Christian Fabian, president of the European Union of General Practitioners and a GP in Sweden told the meeting. The debate was organised by the UK company Medical Futures, with a panel of obesity experts and delegates from the union.
Susan Jebb, head of nutrition and health research at the Medical Research Council in Cambridge, said, "We have a small window of opportunity to do something to slow down this trend, especially in children, before it is too late."
European statistics, which were published in a press briefing at the debate, showed that in most European countries the prevalence of adult obesity has risen by 10%-50% in the past 10 years. In Germany, the current incidence and prevalence of obesity is even higher than that in the United States.
The statistics also showed that rates of childhood overweight and obesity are increasing rapidly in some European counties, with the steepest increases in England and Poland. Obesity in children is higher in southern Europe than in northern Europe, as the traditional Mediterranean diet is replaced by processed foods, which are high in fat, sugar, and salt, however.
European GPs are concerned about the increase in obesity because of its direct association with health problems, such as type 2 diabetes, cardiovascular disease, and hypertension. David Haslam, chairman of the UK National Obesity Forum and a GP in Hertfordshire, England, said, "There is often a mismatch between what patients expect and what they are offered by their GP." He said that in his practice, typically one in four patients was obese yet such patients usually went to their GP with associated conditions, and so their obesity was often not managed directly.
Dr Haslam advocated prescribing medication in patients for whom modifying lifestyle factors have failed. He said that drugs which could help patients and which were inexpensive were often not prescribed "perhaps because of the bad reputation antiobesity medication had a few decades ago."
In a pilot questionnaire sent by Medical Futures to GPs across Europe, the 173 respondents (out of a survey of 1000 GPs) seemed reluctant to prescribe drugs for their obese patients, but about half of them said that they would counsel and educate them.
Most delegates agreed that GPs should not judge or blame their obese patients, but they should broach the subject of weight management with their obese patients, whatever their presenting complaint. They also thought that, as busy GPs, they would not have time to get involved in the wider issues such as lobbying food suppliers, food companies, and the European Union, although they agreed that this was important.(Oxford Rhona MacDonald)
Susan Jebb, head of nutrition and health research at the Medical Research Council in Cambridge, said, "We have a small window of opportunity to do something to slow down this trend, especially in children, before it is too late."
European statistics, which were published in a press briefing at the debate, showed that in most European countries the prevalence of adult obesity has risen by 10%-50% in the past 10 years. In Germany, the current incidence and prevalence of obesity is even higher than that in the United States.
The statistics also showed that rates of childhood overweight and obesity are increasing rapidly in some European counties, with the steepest increases in England and Poland. Obesity in children is higher in southern Europe than in northern Europe, as the traditional Mediterranean diet is replaced by processed foods, which are high in fat, sugar, and salt, however.
European GPs are concerned about the increase in obesity because of its direct association with health problems, such as type 2 diabetes, cardiovascular disease, and hypertension. David Haslam, chairman of the UK National Obesity Forum and a GP in Hertfordshire, England, said, "There is often a mismatch between what patients expect and what they are offered by their GP." He said that in his practice, typically one in four patients was obese yet such patients usually went to their GP with associated conditions, and so their obesity was often not managed directly.
Dr Haslam advocated prescribing medication in patients for whom modifying lifestyle factors have failed. He said that drugs which could help patients and which were inexpensive were often not prescribed "perhaps because of the bad reputation antiobesity medication had a few decades ago."
In a pilot questionnaire sent by Medical Futures to GPs across Europe, the 173 respondents (out of a survey of 1000 GPs) seemed reluctant to prescribe drugs for their obese patients, but about half of them said that they would counsel and educate them.
Most delegates agreed that GPs should not judge or blame their obese patients, but they should broach the subject of weight management with their obese patients, whatever their presenting complaint. They also thought that, as busy GPs, they would not have time to get involved in the wider issues such as lobbying food suppliers, food companies, and the European Union, although they agreed that this was important.(Oxford Rhona MacDonald)