Who gets what treatment for obesity? A survey of GPs in Scotland

Objective: To describe the types and delivery of obesity treatment currentl y favoured by General Practitioners (GPs) working in Scotland. Design: Representative cross-sectional survey using a postal questionnaire which included case stories as stimuli for questions about the GPs' nutriti on guidance to overweight female patients. Subjects: A systematic sample of 1400 general practitioners (GPs) from a to tal of 3593 GPs working in Scotland in 1997. Results: From 1363 eligible GPs, 609 returned the full questionnaire and a further 132 took part in a telephone mini-interview. Net response was 54.4% (741/1363). Almost half of the GPs (45.6%) reported that they had read the recent national clinical guideline for integrating obesity prevention with weight management (SIGN 1996). The majority of GPs (89.6%) agreed that nut rition has an important role to play in the management of disease and 82.4% agreed that they can offer healthy eating advice to patients. However, onl y 34.8% of GPs believed that they had been successful in treating overweigh t patients. Routinely used treatments involve either a dietitian, practice nurse and/or a commercial slimming group and realistic weight loss was cons idered one criteria of successful treatment by some GPs. Age, year qualifie d and location of practice were found to have little influence over variati ons in GP treatment while weak associations between gender of GP and treatm ent were found. Conclusions: The readership of the clinical guidelines in Scotland has been moderate so far although a multidisciplinary approach to obesity treatment is recognised. Further investigations of any relationships between nutriti on education-obesity treatment are needed.