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Patients and HCPs need to improve knowledge of obesity

Tue, 10/27/2020 - 08:02
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Researchers from Israel have reported both patients with obesity and healthcare professionals (HCPs) need to improve awareness regarding the physiologic basis and clinical management of obesity. Specifically, they noted that physicians need to improve how to approach weight and weight management discussions during patient consultations.

The findings from Israel are part of the larger international ‘Awareness, Care & Treatment In Obesity Management – An  International Observation (ACTION-IO)’ study, a survey that is collecting data on perceptions, behaviours and awareness related to obesity and obesity management for people with obesity and healthcare professionals treating obesity. The study has recruited more than 17,200 participants involving people from the general population and healthcare professionals including primary care physicians and specialists who treat patients with obesity.

The ACTION-IO study is designed to identify perceptions, attitudes, behaviours and barriers to effective obesity treatment among people with obesity and physicians in nine countries, including Israel. Findings from the Israeli cohort included 750 patients with obesity and 169 physicians primarily in direct patient care, although physicians specialising in general, plastic or bariatric surgery were excluded.

In total, 66% of physicians considered themselves to be obesity specialists. A majority of patients with obesity (70%) and physicians (95%) agreed with the statement that obesity is a chronic disease and 75% of patients with obesity and 69% of physicians believing obesity has a large impact on overall health. Both groups understood treatments for obesity should be a team effort between different medical professionals (patients with obesity 80%, physicians 90%). However, a lack of trust in the healthcare system as a good resource for weight loss was common among patients with obesity, although the cost of obesity therapy/treatment was not considered to be a significant barrier in Israel.

Patients with obesity largely attributed struggles with obesity to lifestyle factors (62%) with 73% of physicians agreeing that a complete change in lifestyle would be required for patients with obesity to lose weight, 87% of physicians recognized that HCPs needed to contribute to their patients’ weight loss efforts. Patients with obesity and physicians considered unhealthy eating habits (PwO 63%, physicians 89%) and lack of exercise (PwO 73%, physicians 84%) as barriers to weight loss with only 49% of patients with obesity and physicians believed genetic factors influence obesity.

In addition, the paper also reported:

  • Around two-thirds of patients with obesity had discussed their weight with an HCP (physician, nurse, etc.) in the past 5 years; of these, only 44% were diagnosed with obesity and only 17% had a follow-up appointment or call related to weight management scheduled
  • Despite only 9% of physicians stating that they did not feel comfortable bringing up weight loss unless it was mentioned by the patient first, weight management discussions between patients with obesity and HCPs took place a mean nine years after the patients with obesity first started struggling with excess weight or obesity
  • Weight management discussions were initiated by the patient in 47% of cases (32% of patients with obesity total
  • Physicians cited obesity-related complications as the main reason for initiating a weight management conversation
  • The most common reason patients with obesity gave for not discussing weight management with an HCP was a belief that it was their responsibility to manage their own weight (patients with obesity 44%, physicians 5%)
  • For patients with obesity and physicians, general improvements in eating habits (65 and 84%), bariatric surgery (63 and 69%) and increasing physical activity levels (60 and 72%) were perceived as effective weight management methods.
  • Exercise tracking (23 and 42%), over-the-counter weight loss medications (21 and 10%), visiting an obesity specialist (16 and 32%), and sleep quality management (6 and 29%) were all considered less effective weight management methods
  • Prescription weight loss medications were mainly perceived as having low efficacy by patients with obesity, compared with physicians (27% vs 40%)
  • Dietitians (non-physicians) were considered by 82% of physicians to be the most effective professionals in helping patients with obesity

“Overall, the data presented herein suggest that while patients with obesity recognize obesity as a disease, they typically assume complete responsibility for weight management and do not place high importance on the role of physicians. There is a need for physicians to initiate earlier weight loss conversations to actively encourage patients to make lifestyle changes and to recommend referrals to specialists before obesity-related complications develop,” the authors concluded. “To this end, patients with obesity and physicians in Israel have a need to improve their knowledge regarding the biologic basis of obesity and effective ways to approach weight and weight management during consultations that improve patient engagement, empowerment and treatment.”

The paper, ‘ACTION-IO as a platform to understand differences in perceptions, attitudes, and behaviors of people with obesity and physicians across countries – the Israeli experience’, was published in the Israel Journal of Health Policy Research.

The ACTIO-IO study is supported by Novo Nordisk.

To access this paper, please click here