Weight-loss surgery 'not a quick fix': health professionals must be trained in obesity management
Responding to publication of the National Institute for Health and Care Excellence’s (NICE) latest quality standards for Obesity Clinical Assessment and Management, Slimming World, the largest group-based weight loss organisation in the UK and Ireland, warns that surgery is not a quick fix for obesity and that expert support and compassion are key.
Dr Jacquie Lavin, Slimming World’s Head of Nutrition and Research, says: “It’s important for people to realise that choosing surgery is not a light-hearted decision, nor is it the only option for people with a lot of weight to lose, as data shows that, with the right support, diet and lifestyle changes can be extremely effective.
“However, we very much welcome NICE’s clear recognition of the need for post-surgery care packages that combine advice about diet, physical activity and professionally-led or peer-supported groups.”
Dr Lavin explains that Slimming World is seeing an increasing number of new members who have had weight loss surgery but have started to gain weight and need support to start to lose it again. She adds: “There is a general feeling from these members that they are no longer getting support from the NHS after their surgery and have been left to struggle alone.
“NICE’s recommendation of more support as standard after bariatric surgery is a great start and we agree that it should not just be to check nutritional adequacy. It must also ensure the person feels continually cared for in being able to manage their weight and have appropriate support to make the necessary lifestyle behaviour changes. It’s important to recognise the role of compassionate, non-judgemental care and understanding of the emotional and psychological relationships around food and weight control.”
Dr Lavin urges public health commissioners and policy makers to recognise the huge positive impact that commercial weight loss organisations can have on the lives of people with high BMIs. Dr Lavin adds: “Increasingly we’re welcoming people to our groups who don't want to incur the risks of surgery yet have a lot of weight to lose – in fact, a recent analysis of the weight loss records of 1.3 million Slimming World members found that nearly one in three (29.5%) had a starting BMI of at least 35kg/m2 and 12.2% had a joining BMI of at least 40kg/m2. These are often the people who are most likely to be offered surgery.
“In our experience, empowering people to make healthy lifestyle changes, such as improving their diet and becoming more active, can have a huge impact on raising self-esteem and self-confidence by helping people to feel more in control of their own weight and health. Plus these behaviours can be passed on to the whole family, meaning that the next generation and the next grows up with healthy habits too.”
The new NICE standards recommend a series of interventions for people who have obesity but Dr Lavin warns that the common denominator across the board is the skill needed by health professionals in raising the issue. Dr Lavin says: “There is an urgent need for suitable training of all health professionals involved in all stages of obesity management in terms of raising the issue of weight sensitively, handling a conversation around why BMI is being measured and supporting the person to decide on the action they wish to take.
“We believe the government should recommend and support a national training programme for health professionals to help them effectively raise the issue of obesity and weight management. They need the skills to recognise when it would be beneficial to raise the issue of weight in a sensitive and skilled way; to understand the difficulties that people who are severely overweight face, and to recognise the need for compassion, care and understanding in helping them to address the issue.”
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