Management of excess weight in Australian general practice patients: informing practice

Overweight and obesity are highly prevalent conditions that impose a substantial burden on the individual and the society. As the gateway to the health care system, general practice is a promising setting to deliver interventions targeting overweight and obesity. While there has been increasing discussion regarding the role of general practitioners (GPs) in weight management, only a small proportion of overweight and obese patients are offered assistance with managing their weight. The 5As framework (Ask, Assess, Advise, Assist and Arrange) is recommended for the detection and management of lifestyle risk factors in primary care. This framework provides a structure for identifying gaps in the current literature in relation to weight management. The body of research described in this thesis is designed to provide key data in each of the 5As in the framework, to contribute to improving the provision of weight-management care in the Australian general practice setting. The contents of this thesis by publication include an introduction, five data-based manuscripts, a systematic review and a general discussion. At the time of thesis submission, three papers have been accepted for publication in peer-reviewed journals, and the remaining three are under editorial review. These papers examine the measurement and assessment of overweight and obesity and their associated risk factors (Papers One to Three), the effectiveness of lifestyle weight-loss interventions involving GPs (Paper Five), and overweight and obese patients’ current practices and preferences for help with losing weight (Papers Four and Six). The empirical data reported in Papers One to Four, as well as Paper Six, are obtained from the “General Practice Study”, a large, multi-state, cross-sectional study examining the feasibility of implementing computerised health assessments amongst patients presenting to general practices.