In recognition of the need for better resources and to support primary care practitioners in developing a more structured approach to weight management, the National Obesity Forum has developed an interactive educational CD-ROM, which outlines a treatment algorithm and provides practitioners with in-depth information and clear guidelines on how to manage obesity in primary care. This article aims to outline the information and guidelines provided within the package and to consider how primary care practitioners can best utilise this resource.

It is well recognised that obesity substantially increases the risk of morbidity and mortality, particularly in relation to conditions involving the cardiovascular, respiratory and endocrine systems (Conway and Rene, 2004). Primary care organisations are now at the forefront of the management of long-term conditions and as levels of obesity continue to increase so too will the burden of care associated with this complex condition. Those working in a primary care setting are ideally placed to detect, monitor and manage obesity; however, few practitioners have received formal training on this topic (Astrup et al, 2004) and there is a lack of suitable educational resources compared with other areas of chronic disease management.

The purpose of producing an educational CD-ROM was to make available a comprehensive, flexible and interactive tool which would aid practitioners in developing the necessary knowledge and skills to manage obesity in primary care.

The specific aims of the National Obesity Forum’s (NOF) CD-ROM are as follows.

* To inform and update health professionals (primarily GPs and practice nurses) on the causes, consequences and prevalence of obesity.

* To highlight the importance of treating obesity and to recommend a treatment algorithm which will guide practitioners to approach weight management in a structured and cohesive manner.

* To provide detailed guidance on the treatments available to manage adult obesity.

* To outline a framework on how obesity management could be integrated into the existing responsibilities of a primary care team.

* To improve understanding of childhood obesity.

* To provide support materials and suggestions for further reading, and other resources, which aid in the management of obesity.

CD-ROM technology has allowed the information to be presented in two parts. The first part provides for those with limited time and gives practical guidance on all aspects of the obesity management algorithm. The information is presented in an interactive summary format (Figure 1 illustrates the menu screen), enabling users to work through each clearly defined section at their own pace and order of preference/need; this includes video clips of role-played patient-practitioner scenarios as well as graphics and voice-over demonstrations of various techniques, such as how to measure waist circumference (Figure 2). The second part of the CD-ROM is presented in the form of in-depth PDF articles and supports the interactive layer by providing the user with more detailed information and references.

Using the educational tool

Primary care practitioners already manage a wide variety of chronic conditions in their practice populations. The addition of obesity management can therefore be a daunting prospect and many GPs and practice nurses have expressed concern about their level of skill and the capacity of primary care to manage this condition effectively. The NOF educational package provides those working in primary care with a tool which reflects modern technology, is comprehensive in nature and is structured for flexible learning to enable them to better manage obesity in their practices.

The management algorithm can be adapted to fit with local strategies. Users can download tools (such as food and activity recording sheets, and information leaflets for patients) from within the package. The CD-ROM would also complement any relevant obesity training accessed by staff and could serve to update and consolidate any knowledge gained.

The management algorithm

The educational package is built around a management algorithm, which provides guidance on how obesity interventions can be structured in primary care (Figure 3). Simplicity and utility were key concepts in terms of the development of the algorithm. Users are guided through each step of the algorithm and explanations are provided on how to:

* screen and target groups

* raise the issue of obesity and discuss options for intervention

* conduct a clinical and behavioural assessment.

The evidence relating to treatment options, including diet, physical activity, medication and surgery, are outlined in the in-depth PDF files with practical guidance on each of these treatments provided in the interactive part. Non-NHS treatments (such as commercial slimming clubs, self-help books and internet sites) are also considered. The important aspect of long-term weight maintenance is included in the management algorithm.