People living with obesity in the UK take an average of nine years to speak to a doctor about their weight struggles, according to a study led by the University of East Anglia. The study, ‘Changing the narrative around obesity in the UK: a survey of people with obesity and healthcare professionals from the ACTION-IO study’, published in the journal BMJ Open shows that only around half (47 percent) of people living with obesity have discussed their weight with their doctor in the last five years. The study reveals the need for a significant change to address the delay between people's initial struggles with weight and discussions with a doctor for help.
"Obesity is one of the biggest health challenges in the UK, however weight management services currently exist as part of a fragmented health and social care system. Nearly two thirds of people in the UK are living with either overweight or obesity and obesity levels have almost doubled since 1993,” said co-author of the study, Dr Helen Parretti from UEA's Norwich Medical School. "Obesity is a complex disease and a risk factor for several other chronic diseases, including type 2 diabetes, cardiovascular disease and cancer, and it has also been linked to poorer mental health. But with a limited range of services and treatments available, compounded by limited consultation times for UK GPs, doctors have been very restricted on what they could offer those living with obesity. We wanted to find out more about the perceptions, attitudes, behaviours and barriers to effective obesity care."
The Awareness, Care, and Treatment In Obesity MaNagement (ACTION) IO survey involved 1,500 people living with obesity in the UK and 306 healthcare professionals. The team found that instead of seeking help, most (85 percent) of the survey cohort took full responsibility for their own weight loss. However, a smaller proportion of doctors (33 percent) placed the responsibility for weight loss on people living with obesity - demonstrating a recognition for the important role doctors can play in supporting weight management.
"People living with obesity are faced with biological, societal and environmental factors that contribute to obesity, weight stigma and discrimination,” said lead author, Dr Carly A Hughes, GP at Fakenham Weight Management Service and an honorary lecturer at UEA's Norwich Medical School. “This survey has revealed that many people struggle with their weight for years without asking for help from a doctor and think that they are mainly responsible for managing their weight, despite the Royal College of Physicians and the World Health Organisation now recognising obesity as a disease. In contrast, doctors do think that they have a role to play in weight management but in some cases do not introduce the conversation because they incorrectly believe that people with obesity are not interested or motivated to lose weight.
The study also found the presence of obesity-related comorbidities was cited by 76% of HCPs as a top criterion for initiating weight management conversations. The perception of lack of interest (72%) and motivation (61%) in losing weight was reported as top reasons by HCPs for not discussing weight with a patient.
Sixty-five per cent of PwO liked their HCP bringing up weight during appointments. PwO reported complex and varied emotions following a weight loss conversation with an HCP, including supported (36%), hopeful (31%), motivated (23%) and embarrassed (17%). Follow-up appointments were scheduled for 19% of PwO after a weight discussion despite 62% wanting follow-up.
"Primary care is the gateway to effective weight management services in the UK, so an empathetic conversation about weight is crucial to engaging people with appropriate services,” added Hughes. “This survey shows that we must ensure greater access to effective treatments and weight management services for people living with obesity by continuing to remove the barriers to support and challenge the misconceptions amongst healthcare professionals and wider society."
"We also found that three quarters of the healthcare professionals we surveyed cited obesity-related comorbidities as the main reason to initiate a discussion about weight management with patients,” said Parretti. "Healthcare professionals also reported perceptions that their patients would lack interest and motivation to lose weight, as top reasons for not discussing weight earlier." But following a weight loss conversation with a health care professional, just over a third of people said they felt supported, 31 percent were hopeful and 23 percent felt motivated. But 17 percent still felt embarrassed."
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