Adult obesity management in Australia: How can we bridge the gap between guidelines and current general practice?

This is the authors' abstract. We don't add key points for this paper.

Background and objectiveObesity is still recognised as a risk factor rather than a chronic disease in Australia.General practitioners (GPs) have reported a lack of confidence and support in the management of obesity.In this study, we explored GPs' current definitions and treatment of obesity and their attitudes towards proposed clinician educational and billing strategies. MethodsIn this cross-sectional study, an online survey was distributed to GPs across Australia. ResultsOf the 189 GPs who completed the survey, 82% defined obesity, with and/or without comorbidities, as a chronic disease.There is a significant gap between current practice and clinical guidelines, particularly in screening and prevention.The overall attitude towards proposed solutions was very positive.Descriptive analysis was used to present the characteristics of the participants.Chi-squared tests or Fisher's exact test were used to evaluate the relationship between categorical variables. DiscussionAustralia's outdated definition of obesity likely hinders management and contributes to the observed gap between clinical guidelines and current practice.Clinician education on behaviour change and long-term weight management, funding for more enhanced primary care referrals and Pharmaceutical Benefits Scheme listing of pharmacotherapy for weight loss might be possible solutions.OVERWEIGHT AND OBESITY RATES have doubled in Australia in the past 10 years, and it is predicted that more than three-quarters of the population will be overweight or obese by 2030. 1 The World Health Organization has defined obesity as a chronic disease since 1997, 2 with many peak health bodies around the world following suit, including in the USA, Canada and the European Union. [3][4]4][5] In Australia, however, obesity is not nominated as a chronic disease in its own right, but rather simply as a risk factor for other chronic diseases. 6,7his limited definition significantly affects the way that obesity is managed in general practice. 8Currently, there are no specific item numbers in the Medicare Benefits Schedule for obesity management, and there is no clarity around its eligibility for chronic disease management (CDM) billing. [9][10]][11] An association between obesity and poor mental health has been found, with one increasing the likelihood of the other, but there is no consensus on treatment for obesity. [12][13]][14] This study explores how Australian general practitioners (GPs) define and manage patients with obesity.We compare current practice with national overweight and obesity clinical guidelines, set by the National Health and Medical Research Council (NHMRC) in 2013 and The Royal Australian College of General Practitioners (RACGP) in 2018. 15,16We propose several modifications to them for the future.Currently, GPs are left to manage obesity using standard consults. 17Barriers to success cited by GPs in the literature include poor knowledge and low confidence in discussing specific strategies, weight stigma threatening the doctor-patient relationship, lack of local resources and referral options, and inappropriate remuneration. 18,19n 2022, the Australian Government released its first ever national obesity strategy. 20The aim of the strategy is that 'all Australians have access to early intervention and supportive health care'. 20This study will propose two strategies to remedy deficits in GP education and remuneration and contribute to the Australian Government's enablers of 'Us(ing) evidence and data more effectively' and 'Invest(ing) for delivery '. 20 Adult obesity management in Australia: How can we bridge the gap between guidelines and current general practice?