Discussing Options

The public preoccupation with body weight means that there is no shortage of individuals or groups offering the ‘ultimate’ treatment for weight loss. In fact, this is what separates obesity from all other health related conditions. The slimming industry is highly lucrative, and every year billions of pounds are spent by consumers on expensive slimming products that promise to make weight loss an effortless experience. With so many mixed messages provided to the public and with so much focus on the aesthetic aspects of weight loss, it is necessary to be very clear about the purpose of embarking on a medically directed weight management programme.

While weight may have been raised with a patient in the practice this does not mean that only NHS-directed options can be considered. It may be that a non-NHS option is the most appropriate choice for an individual. This will depend on a number of factors including the range of options available within a locality, the patient’s previous experience of non-NHS treatments, the degree and complications of obesity that a patient has and whether the patient feels comfortable to proceed with a treatment outside of the NHS.

The range of options includes commercial slimming clubs, leisure services, exercise referral schemes/walking programmes, home-based programmes (e.g. popular diets, internet-based programmes). In order to give guidance about appropriate non-NHS options, practitioners need to be familiar with and happy with the philosophy of the particular programme. To gain a better understanding it may be a good idea to invite key individuals such as leisure service co-ordinators to the practice to discuss their approach to weight management clients. A local dietetic service may be able to provide advice about local commercial slimming clubs. Reputable clubs are more likely to agree to be assessed using established local criteria. For some patients non-NHS routes may not be the first option but this may well change as treatment progresses e.g. to help maintain weight lost, referral to a local exercise scheme could be very beneficial. Also if a patient has become disillusioned with their dietary progress they may well opt into a commercial slimming group to follow a particular ‘plan’ to help them to get back on track.

The following section provides information about non-NHS routes. Information about popular diets is also included. Details about exercise referral schemes and walking programmes can be found in the Physical Activity section of the Treatment module.