Surgery to treat obesity could be avoided if GPs and healthcare trusts put more time and money into early stage weight management programmes.

That is the view of Nick Finer, clinical director at the Wellcome Clinical Research Facility at Addenbrooke's Hospital in Cambridge. Speaking at the British Pharmacological Society’s winter meeting in Brighton, he called for anti-obesity drugs to be more widely used, although patients still face a “post code lottery” when seeking access to specialist care.

He said that about one-third of people taking obesity management drugs, in conjunction with a diet and lifestyle programme, will achieve maintained weight loss and drug treatment has also been shown to delay or prevent the development of type 2 diabetes, reduce cardiovascular risk factors and improve well-being.

However, despite National Institute for Health and Clinical Excellence guidelines,”there is a reluctance of primary care doctors to treat obesity, with or without drugs, and thus the early potential for drug treatment to prevent the later need for surgery in some people is missed,” Dr Finer noted. “There remains a strong antipathy from many doctors, primary care trusts and specialist commissioning groups to invest in obesity management.”

He went on to say that NICE guidelines, “and even more seriously previous Health Technology Assessments,” remain to be implemented. There is “a complete post code lottery for patients to access specialist care”, he added, and “until the Quality and Outcomes Framework system remunerates GPs for undertaking weight management there will be little stimulus for adoption of current evidence-based treatment guidelines.”