16/10/2018 13:05 BST | Updated 16/10/2018 13:05 BST

Most GPs Are Not Recommending Exercise To Patients - What's Stopping Them?

Doctors and patients share their views.

Doctors are being urged to prescribe exercise after Public Health England found nearly three quarters of GPs do not speak about the benefits of physical activity to patients.

One in four patients would be more active if advised by a doctor or nurse, according to PHE yet medical professionals are reluctant to broach the topic “due to either lack of knowledge, skills or confidence”.

A new “Moving Medicine toolkit”, will provide information for health workers on how to initiate conversations about exercise to patients being treated for a wide range of illnesses, from depression and diabetes to dementia and cancer. However why do we need it in the first place?

Doctors have told HuffPost UK hurdles such as obesity stigma and short appointment times are preventing them from recommending exercise, while patients have said they would welcome the fitness reminder. 

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Dr Aseem Malhotra, an NHS consultant cardiologist and Professor of Evidence-Based Medicine, believes some doctors may be reluctant to discuss lifestyle changes such as diet and exercise with patients if they are overweight themselves.

“We know among the adult UK population about 60% are overweight or obese and it’s the same among healthcare professionals including doctors and nurses,” he said.

To package exercise in a simple yet powerful way is really crucial.

“I think that is an element. If yourself, you don’t epitomise health, if you don’t look the part, naturally, probably to some degree it might make it difficult; doctors might be embarrassed if they’ve got a pot belly sitting opposite patients to say: ‘You need to change your diet and to do more exercise.’” 

He said he agrees with PHE that ‘knowledge’ may also be preventing some doctors prescribing exercise as many will not have been taught exactly how to do this. Dr Malhotra, who’s conducted research into the benefits of exercise, advises making tangible, prescriptive recommendations, such as taking a brisk 30-minute walk each day. 

“To package exercise in a simple yet powerful way is really crucial, but a lot of doctors probably aren’t aware of this. It’s not something we are specifically trained in in medical school,” he noted. 

“In general I tell my patients – and I am probably one of the few doctors who do this – that small, relatively simple lifestyle changes that you introduce into your day-to-day routine will be much more powerful than any combination cocktail of drugs that I can give you.”   

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Dr Andrew Boyd, joint clinical champion for the Royal College of GP’s Physical Activity and Lifestyle programme, told HuffPost UK NHS restrictions may be contributing to the lack of exercise information patients receive. 

“GPs often have discussions with our patients during consultations about healthy lifestyles, including taking more exercise...but GPs and our teams are currently working under intense resource and workforce pressure, and we are constantly being told to do more during our consultations with patients – all within the constraints of a standard 10-minute appointment,” he said. “Fitting everything in can be impossible, especially if these issues might not be the reason a patient has come to visit the GP.”

In regards to potential stigma associated with recommending exercise in appointments, he added: “GPs are highly trained medical professionals and part of our training is to have non-judgemental conversations with patients about their health, and to try to involve them in their care – but further support to have what can be sensitive conversations, in sensitive circumstances is always welcome.”

In response to the latest news, patients have told HuffPost UK they would welcome more information from GPs on exercise. 

Bryony Hopkins, 26, from London, has been prescribed countless drugs to help manage Crohns Disease – a autoimmune disease which attacks the inside of the digestive tract, which she has lived with for 20 years. She would like to know how exercise could improve her symptoms. 

“Throughout my time with the illness, I have suffered at the hands of many different toxic medications, including steroids and other immuno-suppressant drugs. These often have huge and life changing side effects, like hair loss and weight gain, and it can be completely demoralising to find you are waiting to get better, whilst experiencing such side effects,” she said. “I think it would be beneficial for doctors to consider lifestyle factors, like diet and exercise, as a way to complement treatment plans. Whilst I don’t think exercise can replace medication in many cases, I do think it could be a huge force for good in terms of looking at the body in a wholly holistic way.”

Others on Twitter agreed, with some sharing the positive experiences they’ve already had: