A survey of nurses has revealed almost half doubt whether obese patients have the motivation to change their weight.
The poll of around 400 nurses found that 45% do not believe obese people have the desire to alter their behaviour, while 8% think obese patients are lazier than people of average weight.
But the study also found that many nurses have weight problems themselves, with 14% classed as obese, and 29% being overweight.
Practice nurses, district nurses, and health visitors in the north of England were quizzed for the research in the Journal of Advanced Nursing.
Around 5% of nurses actually think the health risks of being obese are overstated, and 4% said they feel disgusted at chronically overweight patients.
However, despite this, 47% of nurses said they found helping obese patients very rewarding.
Lead researcher, Dr Ian Brown from Sheffield Hallam University, said: "Primary care nurses have an important role when it comes to helping patients to tackle obesity, which can lead to diseases like coronary heart disease and diabetes.
"But they clearly need further training and organisational support to provide the help that obese people need to lose weight, in line with new UK health guidelines.
"Any training programmes should also address nurses' beliefs and attitudes.
"While outright negative stereotypes were rare, a number of nurses displayed potentially negative beliefs and attitudes relating to obesity and obese people."
<www.journalofadvancednursing.com> Journal of Advanced Nursing
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"I work in an area with a high rate of obesity and agree with many of the comments already highlighted. Lack of time to spend with patients is a major barrier. I have found very positive results from patients who have been really determined to change, but on the other hand there are an equal number of patients who do not wish to change. It is important that we offer as much support as possible, but we also need to respect patient autonomy." - Elaine Clarkson, practice nurse, Merseyside
"I have several obese patients that I monitor reglarly. They seem to enjoy the input. If confidence is built, some weight loss is often achieved, but difficult when associated with depression" - Name and address supplied
"Patients may not have the willpower to change without support, so obesity training for staff should prove fruitful if it changes the patient's mindset and brings about a positive change in their nutritional intake so as to decrease their weight - however little" - Cynthia Mitchell, Manchester Mental Health and Social Care Trust
"The majority of obese patients would prefer to be average weight. I feel that willpower alone is not sufficient - they need support, advice and encouragement from suitably trained staff. As a practice nurse I have had some training but time required to do this properly is not available." - J McQuarrie, Dumfries and Galloway
"There is already a lot of info out there, the basics are fairly straightforward. However, life can be difficult and put barriers in the way of all of us. Patients often have very negative attitudes and belief systems that block their ability to change, and nurses/GPs banging on about healthy lifestyles and exercise does little to help. What these folks need is a trigger to motivate them to change and that is the hardest thing to do. Training that helps me to do that myself would be great. I have osteoarthritis in my knee and asthma and have gained weight with steroid use so I know exactly how my patients feel. I have only gained a stone but I struggle to shift it." - Anne, ANP practice nurse, Kidderminster
"I believe with encouragement and the ability to empower the obese patient to enable them to change they will, but it would help if the person nursing them believes in them, surely that is part of our duty to the patient" - Julie Grange, currently in ACT but usually in Hants
"Obese people have no less willpower than those patients who are not obese. As with any change, lifestyle or otherwise, it is our desire to change that makes the difference between success and failure. Primary care nurses are in the ideal position to help motivate the desire to change and to support that change - unfortunately, there isn't always the time or training in primary care to spend with patients to help them with this important change. Many obese patients feel that all their healthcare problems are perceived by health professionals as being caused by being overweight and so don't present, often thinking that they will get the usual lecture about losing weight. The primary care team need to be tactful and diplomatic when discussing the need to lose weight" - Norma Boyt, Practice Nurse, Carmarthenshire
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