I was interested to read the SIGN notes for discussion with patients on the management of obesity in children and young people (Guidelines in Practice, September 2004).

The question the article raised in my mind was whether we should be more active in helping children and young people who have started the slide into obesity.

Obesity has become a public as well as an individual health problem. Should health visitors be taking it on? Should school nurses be employed to measure schoolchildren and identify those at risk?

Greg Critser’s book Fat Land quoted one commentator who said, “Obesity is the natural response to the American environment”. Obesity is now becoming the natural response to the British environment.

The article, which recommends helpful sources of advice and information, nicely steers one into a behavioural approach to the problem. Bad eating habits and playing computer games are behaviours that children can drift into.

The obesity epidemic has to be tackled on many fronts, from the sale of school playing fields, to advertising and the food industry, but when worried parents or distressed children present to us, this article’s advice will prove invaluable.

Dr Chris Barclay, GP, Sheffield

I am sad to see that some GPs would consider opting out of cervical cytology screening because their payments may be slightly lower this year (‘Our panel of experts answer questions on the new contract’ Guidelines in Practice, August 2004).

Patients deserve to receive the same level of care as previously, while incentives should encourage higher, not lower, standards. I hope that most GPs do not share this attitude.

Helen Batchelor, Practice Nurse Manager/Clinical Governance Lead, Sutton and Merton PCT

Guidelines in Practice, November 2004, Volume 7(11)
© 2004 MGP Ltd
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