GPs 'Could Do More' To Help Obese Avoid Surgery, UK
Editor's ChoiceMain Category: Obesity / Weight Loss / Fitness
Also Included In: Primary Care / General Practice
Article Date: 17 Dec 2008 - 0:00 PDT
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Obesity could be treated earlier by GPs and healthcare trusts if they invest more time and money in early stage weight management programmes, therefore avoiding the potential need for surgery later on, a senior clinical researcher will report today (Wednesday, 17 December, 2008). He will also say that there is a "post code lottery" for patients suffering from obesity, when it comes to getting 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.
About the Winter Meeting
The BPS Winter Meeting will be held at the Hilton Brighton Metropole Hotel from Tuesday, 16 December, to Thursday, 18 December, 2008.
Joint symposium on obesity and metabolic diseases - Clinical Pharmacology Section:
Organisers: Dr Albert Ferro, Kings College London, UK and Sharon Cheetham, RenaSci, UK
09.00 New targets - peripheral obesity
Dr Ben Field, Imperial College London, UK
09.40 New Central Targets for the Treatment of Obesity
Dr Bruce Sargent, AMRI, USA
10.40 Clinical challenges: can current drugs compete with surgery?
Dr Nick Finer, Wellcome Clinical Research Facility, Cambridge, UK
11.20 Regulatory challenges for new drugs to treat obesity and comorbid metabolic disorders
Professor David Heal, Renasci, UK
Supported by RenaSci and AMRI
Additional lectures:
Dr Andrew Kicman (Kings College London): 'Pharmacology in sports/Olympics' (17 Dec)
Professor Arthur Weston (University of Manchester): Potassium channels and myo-endothelial crosstalk in blood vessels: a pharmacologist's view' (18 Dec)
Kirk Leech / Corina Hadjiodysseos: 'Animal research: Winning the debate' (18 Dec)
For further information about the BPS Winter Meeting click here.
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Source:
University of Manchester
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Visitor Opinions In Chronological Order (1)
Bariatric Surgery
posted by Dan on 17 Dec 2008 at 8:45 amRegarding Obesity:
Gastric bypass surgery is a type of bariatric surgery that essentially reduces the volume of the human stomach in order to correct and treat morbid obesity by surgical re-construction of the stomach and small intestine. Morbid obesity is defined as one who has a body mass index of 30 kg/m or greater, and this surgery, along with the three other types of surgery for morbid obesity, should be considered a last resort after all other methods to reduce the patient’s weight have chronically failed. There are three surgical variations of gastric bypass surgery, and one is chosen by the surgeon based on their experience and success from the variation they will utilize. Over 200,000 gastric bypass surgeries are performed each year, and this surgery being performed continues to progress as a suitable option for the morbidly obese. There is evidence that this surgery is particularly beneficial for those obese patients that have non-insulin dependent Diabetes Mellitus as well.
Morbid obesity greatly affects the health of the patient in a very negative way. It has about 10 co-morbidities that can develop if the situation is not corrected. Some if not most of these co-morbidities are life-threatening. So the surgery to correct morbid obesity greatly reduces the co-morbidities associated with this type of obesity problem. Two percent of those who undergo this surgery die as a result from about a half a dozen complications that could occur. However, the surgery reduces the mortality of the patient by 40 percent or so, yet this percentage is debatable due to conflicting clinical studies.
Age of the patient should be taken into consideration, as to whether or not the risks of this surgery outweigh any potential benefits for the patient who may have existing co-morbidities that have already caused physiological damage to the patient. Also what should be determined by the surgeon is the amount of safety, effectiveness, and rationale for a particular patient regarding those patients who are elderly, for example.
If a person or a doctor is considering this type of surgery, there is a website dedicated to bariatric surgery, which is: http://www.asmbs.org,
Dan Abshear
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