Literature review of nursing practice in managing obesity in primary care: developments in the UK.

AIMS AND OBJECTIVES: To review empirical studies reporting primary care nursing practice in relation to obesity management for adults in the UK; to place these in the context of policy and professional developments.

BACKGROUND: Obesity is recognized as a public health problem in many parts of the world. The UK has a well-developed system of primary care nursing with experience of initiatives to tackle obesity.

METHODS: Searches of electronic databases supplemented by hand-searching of identified leads and key journals. Data extracted and analysed following methods for an integrative literature review.

FINDINGS: Eleven empirical studies were reviewed. Obesity management developed as part of the role of general practice nurses after 1990. Nurses' role has been mainly in providing one-to-one support to within surgery or clinic consultations; and to a lesser extent group based support sessions. The interventions could be characterized as general oral advice about nutrition and lifestyle. There was no evidence of positive outcomes for patients from these interventions. In some contexts, oral advice extended to calorie deficit diets and more developed referral options about physical activity. Two studies examined outcomes of practice following attempts to implement evidence-based protocols. The evidence of outcomes from these is mixed. At best, perhaps 10% of patients entering a nurse led support programme may achieve a clinically significant weight loss.

CONCLUSIONS: There is potential in primary care nursing to help patients manage obesity but caution is needed. Despite practice developments in the UK the outcomes for patients remain unclear. RELEVANCE TO CLINICAL PRACTICE. It is important to follow a structured programme in supporting patients with weight loss within an holistic assessment of their needs.