A qualitative study of general practitioners' and practice nurses' attitudes to obesity management in primary care.

OBJECTIVES: To examine general practitioners' (GPs) and practice nurses' (PNs) perceptions of obesity, their strategies and attitudes towards weight management, and their views on the major obstacles to (and need for) better weight management in primary care.
METHOD: A qualitative study was carried out using semi-structured interviews with GPs and PNS within the Greater Glasgow Healthboard area.
RESULTS: GPs and PNs understood the problem of obesity but generally had little enthusiasm for weight management. Most of the GPs felt it was an inappropriate use of their time and passed obese patients onto the PNs; the PNs felt that obese patients were "off-loaded" onto them. Stated management objectives were aimed at "healthy lifestyle" rather than "unrealistic" weight loss, yet frustration at "lack of success" was a major theme. Lack of motivation on the part of the patient was seen as the major problem. GPs were keener to be directly involved when a concomitant disease was present. Suggested requirements to improve weight management at the level of primary care included more time, better facilities, community dieticians and more training courses. However, many felt that Government, media and public health had to take a leading role in order to deal with the problem effectively.
CONCLUSIONS: A comprehensive and integrative primary care-led approach to weight management may be possible but will need substantial shifts of resources, organisation, training and attitudes in order to maximise its potential impact.