Most GPs find it difficult to bring up the topic of child overweight and obesity during consultations, however such a move would probably be appreciated by most parents, new research indicates.

Childhood overweight continues to be a major public health problem, but while the role of GPs is seen as important in tackling this issue, it also remains undefined, with many GPs unsure of how to even bring the topic up.

Researchers from Trinity College Dublin (TCD) and Tallaght Hospital in Dublin decided to look into this further by carrying out two studies - the first looking at the attitudes of GPs themselves and the second involving weight checks of children during GP consultations.

The first study focused on what GPs think about childhood overweight and obesity. Over 500 GPs - 20% of all GPs in Ireland - were surveyed about this issue.

It revealed that a majority of GPs strongly believe that childhood obesity is a medical problem, but they also believe that parents do not share this view.

Less than 4% of those surveyed said that they consistently check the weight of children during consultations and when it comes to consultations involving overweight children and their parents, just 8% always bring the issue up for discussion.

Almost 90% of GPs admitted that they find it difficult to discuss this issue when dealing with overweight children and their parents.

The researchers noted that ‘GPs are very concerned, but feel unable to act systematically on this issue' due to concerns about upsetting the child and/or their parents.

In response to these findings, the researchers decided to systematically check the weight of 500 children aged between five and 12 in 10 different GP practices.

Eleven GPs were involved and each took a simple 30-minute elearning module designed by the Irish College of General Practitioners (ICGP), which contained relevant information, such as how to use the correct weighing technique, as well as several video consultations related to checking the weight of children.

The GPs then asked the parents of children in the relevant age group, who were coming in for routine care, if the child's weight could be checked as part of the consultation. After the consultation, each parents was surveyed to find out how they felt about having their child weighed by their GP.

As expected, at least one quarter of the children were overweight and of these, almost half were obese.

The study found that almost every parents (98%) felt that the weight check had been useful and just 4% indicated that the move had caused their child to become upset, anxious or angry.

Almost three out of four parents of obese children said that their child was not upset about having their weight checked.

The researchers also looked at which children were most likely to become upset and found that these were mostly older children and that when it came to five and six-year-olds, none were upset.

"We concluded that an overwhelming proportion of these parents welcomed GPs' screening for overweight, and that children aged five to six years were among the most receptive and least likely to respond negatively," they commented.

They said that from looking at both studies, they concluded that even though GPs are ‘clearly apprehensive about checking the weight of children, when they began to do so systematically, it fitted easily into consultations, and was appreciated by parents, even among parents of most overweight children'.

They noted that while the GPs in this study were capable of skillfully communicating about this sensitive topic, another elearning module on further reducing any potential upset ‘would be appropriate'.

The researchers also pointed out that if GPs and practice nurses regularly checked the weight of their younger patients, they would likely become more relaxed about this issue and also more efficient.

They acknowledged that certain words, like ‘fat' and ‘heavy' are probably better not used. Instead, simply using the term ‘overweight' or ‘finding a better weight' should be considered.

"Finally, it is perhaps best to focus on the family, as it is usual that parents of overweight children are themselves overweight. Consider solutions for the whole family, as opposed to a problem-orientated focus on any individual child," the research team suggested.

The ICGP elearning module on consultations skills is available on the ICGP website here.

Details of these studies are published in Forum, the Journal of the Irish College of General Practitioners.