Integrating diet, physical activity and weight management services into primary care

Evidence shows that services offered in primary care can be effective in helping people to stabilize or reduce their body weight, increase levels of physical activity and shift to a healthier diet. A new report by WHO/Europe explores some of these services, summarizes the evidence on their effectiveness and provides a structured analysis of the reasons for suboptimal service delivery. It concludes with guidance for transforming countries’ health services to improve the coverage and quality of those that promote healthy diets, physical activity and weight management.

More progress needed

Countries have recognized the important role of primary care in helping to prevent and manage conditions related to unhealthy diets, physical inactivity and obesity. The WHO European food and nutrition action plan 2015–2020 and the Physical activity strategy for the WHO European Region 2016–2025 both stress the importance of reaching the population through primary care to support behaviour change and the long-term management of obesity and other conditions.

However, the delivery of services in primary care to assess, advise and assist patients on diet, physical activity and weight management still remains suboptimal across the Region, and the development and implementation of guidelines and services have been uneven at the national level. As such, there is much work to do in terms of scaling up the provision of quality services. The 2016 adoption of a WHO European framework for action on integrated health services delivery is timely, and reinforces WHO/Europe’s focus on this theme for the coming years.

Policy recommendations

The new report “Integrating diet, physical activity and weight management services into primary care” concludes that further systematic reviews and robust analyses are needed. However, the literature already points to general principles for the design of services that can provide a good foundation for future work. In particular, it shows that services which simultaneously address diet and physical activity are more effective than separate services; that enrolment by primary care physicians and routine follow-up by nurses and allied health professionals yields better health outcomes than services relying on traditional physician appointments alone; and that self-management support – from, for example, peer groups and web-based interventions – is necessary to ensure patient engagement and motivation.