Warns physicians against attributing all symptoms to weight, emphasises the need to remember that he child may have had the issue raised many times before
Physicians treating children and young people should be mindful of flagging obesity or weight-related issues, be sensitive when they do so and refrain from attributing all symptoms to weight problems, a new guidance put out by the National Institute of Health and Care Excellence (NICE) in the UK has laid down in a new guidance.
All discussions should be carried out without judgement and doctors should be conscious of their own biases during the discussion. Doctors need to have context about the patient’s daily schedule, medication if any and family history of obesity so that they can contextualise the conversation without affecting the patient’s morale. If the patient or their family are not comfortable, the conversation thread about obesity should not be pursued.
“Ask permission to discuss overweight, obesity or central adiposity. If they do not wish to discuss it further on this occasion, respect the person’s choice (and that of their family or carer, if relevant) and either explore the reason sensitively or delay discussion until an appropriate time. Record the outcome of the discussion to ensure that subsequent healthcare professionals are aware that the matter has been raised, and know about the person’s views and any actions already taken to manage overweight or obesity,” reads the document that came out earlier this month.
Physicians have been advised to be conscious of the person’s beliefs, cultural and religious and refrain at all times from using stigmatising language. They need to use their clinical judgement to decide whether the matter of the child’s weight needs to be discussed as part of their duty of caring for their patients.
The committee which came out with the new guidance also came out with a rationale that included among other things the need to ensure that the categorisation as overweight or obese does not have negative connotations for a young person. “The committee agreed that families and carers should take primary responsibility for behavioural changes in children and young people. But they recognised that it was appropriate for children to start to be empowered to manage their overweight or obesity around the age of 12, although this will vary depending on an individual child or young person’s level of maturity and understanding,” says the document.
