Technical Paper 1:
Obesity in Australia: a need for urgent action

4.7.3 - Primary healthcare settings

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In tackling obesity, it is crucial to target patients in primary care settings, at all levels of prevention: that is, to reduce the chance that excess weight will affect a patient, to interrupt, prevent or minimise the progress of unhealthy weight gain at an early stage, and to attempt to halt and reduce existing disability and damage associated with unhealthy weight gain. Given the prevalence of overweight and obesity in the community, adults, adolescents and children who are overweight or obese need to be offered services and support to ensure that they at least do not continue to gain weight and ideally to ensure that they lose weight. The Taskforce has considered policy initiatives in primary healthcare settings such as the implementation and monitoring of brief interventions about nutrition, physical activity and management of overweight and obesity, including an expansion of the ‘Lifescripts’ (lifestyle prescription) program in primary care.

The importance of access to culturally appropriate primary healthcare services (both mainstream and Aboriginal and Torres Strait Islander services) at a level commensurate with need is highlighted in the National Indigenous Health Equality Targets in the ‘Close the Gap’ report, and these must be implemented.[171]

Brief GP interventions incorporating verbal advice and written materials can lead to short-term modification of physical activity behaviours.[111] Common factors in improved, more consistent changes in physical activity behaviours include:

  • GPs and other health professionals working together
  • Patients receiving counselling outside usual GP appointments.
GPs want to see their role supported through community education campaigns, so that people expect them to provide advice as part of routine medical care.[137] A key component of an effective and comprehensive social marketing campaign is linkage with community agencies such as health professionals to support and reinforce key messages (such as through the provision of campaign information and resources). GPs also want clear referral pathways to dietitians and physical activity providers, with simple systems for people to be reimbursed for weight management referrals.[137]
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The ‘Lifescripts’ program is a national, evidence-based initiative that promotes risk factor management in GP and primary healthcare services. Lifescripts resources provide GPs with a framework for:
  • raising and discussing lifestyle risk factors with patients
  • advice in the form of a written script and associated patient education
  • referral to other providers to support healthy lifestyles.
This comprehensive approach to encourage achievable health behaviour change is needed for sustainable population health behaviour change. Behavioural changes need to be easy to make; for example, following the health promotion message of making healthy choices, easier choices.[117, 124, 129, 169, 174, 175] ‘Lifescripts’ requires additional funding to expand the program, provide linkages to local services and to integrate it with national campaigns. As a widely adopted, dedicated general practice-based lifestyle program, ‘Lifescripts’ would have the potential to improve the identification and management of people who are or are at risk of being obese or overweight and thus reduce associated healthcare costs.

Fund programs to educate patients in primary healthcare settings about nutrition, physical activity and management of overweight and obesity.

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