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© World Obesity Federation

Obesity is widely-recognised as a major threat to public health. It is a major risk factor for cancer and heart disease, and is associated with complications of surgery and pregnancy.

There is evidence that GP referrals to community weight loss programmes are effective, but funding for these has been removed in some parts of the UK, leaving GPs with no referral options. In this study, researchers from Oxford University asked GPs to offer referrals to a weight loss programme that required them to pay for the service themselves.

The cost of the programme was framed either as an absolute cost – about £5 or £6 per week or as about the same amount as a couple of cups of takeaway coffee per week. Sixty patients with a BMI of over 30 were recruited. 

About half accepted the referral offer, with no difference between the two ways in which the costs were framed, but only one person out of 28 participants accepting the offer actually attended the programme. This is much lower than the 40% who attended in a previous study of an NHS-funded weight loss or programme.

The authors advocate the provision of large-scale public weight-loss programmes to maximise the opportunities for GP interventions to treat obesity. 

Professor Paul Aveyard from Oxford University said ‘We know that NHS-funded weight management programmes save money for the NHS in the long-run by  reducing the risk of diseases like diabetes, high blood pressure, and heart disease.  When doctors offer a referral to patients on the NHS, it shows patients that their doctor thinks this is important and people agree to referral and attend and lose weight.  Asking patients to pay for themselves devalues the referral and uptake of support is very low.’


Brief interventions for obesity when patients are asked to pay for weight loss treatment: an observational study in primary care with an embedded randomised trial. 
Kate Tudor, Susan A Jebb, Indrani Manoharan and Paul Aveyard.
British Journal of General Practice 24 February 2020; bjgp20X708797.

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