Advice line - Helping overweight patients

We are all too aware of the obesity epidemic. In fact, as physiotherapy staff, irrespective of our area of clinical interest, we have all encountered the impact of obesity on health. The National Institute for Health and Clinical Excellence recommends that all staff in primary and secondary care, including physios, ensure that preventing and managing obesity is a priority at both strategic and delivery levels.

A good way of providing brief opportunistic advice is to ‘ask, advise, assist’. First, ‘ask’ or raise the issue during day-to-day contact. This can seem daunting and requires sensitivity but have confidence in our core therapeutic communication skills. Once we have built rapport, we can start with a non-confrontational open-ended question, such as: ‘How do you feel about your weight?’. If we receive a ‘green flag’ we can go on to the next stage: ‘advise’. We can provide positive messages about healthy weight by, for example, saying: ‘A balanced diet can reduce the risk of cancer, heart disease and stroke and physical activity can also reduce stress, help you feel happier and reduce signs of ageing.’  We can provide practical tips to achieve a healthy weight by saying, for example, ‘eat three regular meals daily, including breakfast’ and ‘build up activity levels slowly and at your own pace’.

Finally ‘assist’: once we have given brief opportunistic advice, it is up to the service user what they do with it. However, in all cases, we can offer assistance. If he or she is not ready to change or wants to go away and think about it we can tell them who they can talk to in the local area if and when they are ready. If a user wants to more or to change, we can offer information, such as leaflets or websites to help them. We can signpost them to appropriate local services, refer to dietetic or psychology colleagues, provide contact details and support them in making initial contact.

If delivered credibly, brief opportunistic advice can improve patient experience and, in the longer-term, patient outcomes. It can help us demonstrate that we offer high-quality services in line with national outcomes frameworks and local health and wellbeing strategies. And if funding is being diverted to deal with the obesity epidemic, can we afford not to?

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