Abstract:
Background: Obesity related disease is epidemic and management is failing. A Request for Proposal (RFP) to develop a pragmatic ‘tool’ for Supporting Weight Management in Primary Care was announced by the Ministry of Health (MoH). Health provider institutions were asked for responses. The basis of the brief was: Aims: “An evidence-based brief opportunistic intervention (BOI) tool for general practice to support weight management. Phase 1 develop advice and resources (a tool) for primary care practitioners (PCP) on how to raise the issue of weight management and communicate effectively with patients Phase 2 trial the tool in 10-15 practices including subsidising those with high Maori, Pacific and low income enrolled populations, evaluate and modify the tool Phase 3 make tool available nationally.” Methods: We educated PCP’s on 1) human specific evolution that endowed humans with large brains, strong appetite pathways leading to loss of control (addiction) to high energy processed food1, and obesity 2) thousands of plant food nutrients augment basic energy and toxin management biochemistry for health2, without which degenerative disease results. The ABC framework3 was adapted to ABO - Ask, (without judgement/with an awareness of ‘junk food addiction’ about concerns around weight/shape or eating control), BOI (eat more vegetables/fruit, be more active), Offer Ongoing Overweight care (comprehensive follow-up, and referral, packages) to interested patients. We adapted a ‘readiness to change’ screening questionnaire and inserted the programme into locally used electronic practice management systems (PMS) with drop down prompts and data recording fields. Results: We won the RFP and will present the development of the programme and the beginning of the pilot in the general practices. Discussion: It is vital to critique preventative and therapeutic obesity programmes in primary care. New evidenced-based hypotheses may be required. Much basic nutrition and metabolic science can be translated into innovative but pragmatic programmes.
