Perceptions of Barriers to Effective Obesity Care: Results from the National ACTION Study

Abstract

Objective: ACTION (Awareness, Care, and Treatment in Obesity maNagement) examined obesity-related perceptions, attitudes, and behaviors among people with obesity (PwO), health care providers (HCPs), and employer representatives (ERs). Methods: A total of 3,008 adult PwO (BMI 30 by self-reported height and weight), 606 HCPs, and 153 ERs completed surveys in a cross-sectional design. Results: Despite several weight loss (WL) attempts, only 23% of PwO reported 10% WL during the previous 3 years. Many PwO (65%) recognized obesity as a disease, but only 54% worried their weight may affect future health. Most PwO (82%) felt "completely" responsible for WL; 72% of HCPs felt responsible for contributing to WL efforts; few ERs (18%) felt even partially responsible. Only 50% of PwO saw themselves as "obese," and 55% reported receiving a formal diagnosis of obesity. Despite HCPs' reported comfort with weight-related conversations, time constraints deprioritized these efforts. Only 24% of PwO had a scheduled follow-up to initial weight-related conversations. Few PwO (17%) perceived employersponsored wellness offerings as helpful in supporting WL. Conclusions: Although generally perceived as a disease, obesity is not commonly treated as such. Divergence in perceptions and attitudes potentially hinders better management. This study highlights inconsistent understanding of the impact of obesity and need for both self-directed and medical management.

Awareness, Care and Treatment In Obesity maNagement to inform Haemophilia Obesity Patient Empowerment (ACTION‐TO‐HOPE): Results of a survey of US patients with haemophilia and obesity (PwHO) and their partners and caregivers

“…In both studies, 44% of patients believe that it is their responsibility to manage their weight with most acknowledging lifestyle change as necessary 21. Many findings of the current study were similar to those of ACTION.…”

“…[8][9][10][11][12][13][14][15] Data on bleeding tendency in obese PwH are largely inconclusive; however, some individuals may experience reduced joint bleeds following moderate weight loss. 21 PwO and HCPs in ACTION generally reported that the most frequent strategies employed were general recommendations to eat less and to be more active. 18,19 Conventional weight-based dosing of factor replacement leads to increased costs for people with haemophilia and obesity (PwHO), suggesting pharmacoeconomic benefits of weight loss.…”

“…3,6,16,17 Limited data exist on the longitudinal impact of obesity and changes of weight, which are mostly derived from case reports. 21 In contrast, general evidence-based recommendations for successful WL include behavioural modification and lifestyle modification strategies that go beyond simple guidance to reduce caloric intake and increase physical activity (4%-8% loss), such as pharmacotherapy (5%-12% loss) and bariatric surgery (14%-33% loss) in appropriate patients. 9,20 The Awareness, Care and Treatment In Obesity MaNagement (ACTION) study examined obesity-related perceptions, attitudes and behaviours among people with obesity (PwO), healthcare providers (HCPs) and employer representatives (ERs).…”

Associations between Lifetime Adversity and Obesity Treatment in Patients with Morbid Obesity

“…The importance of building healthy therapeutic relations between patients and healthcare providers was demonstrated in a recent study that assessed patient perspectives in the role of primary care in obesity management [9]. Also, another recently published study revealed divergence in perception and attitudes between patients with obesity and HCP’s perspective of obesity treatment [10]. Although assessments of psychological issues are considered essential for the identification of the optimal treatment choice at an individual level, the influence of an individual’s psychological health on obesity treatment is not known.…”

Awareness, Care and Treatment In Obesity maNagement to inform Haemophilia Obesity Patient Empowerment (ACTION‐TO‐HOPE): Results of a survey of US haemophilia treatment centre professionals

“…21 Through an assessment of PwO, HCPs and employer representatives, the ACTION study demonstrated that although generally perceived as a disease, obesity is not commonly treated as such. 21 Through an assessment of PwO, HCPs and employer representatives, the ACTION study demonstrated that although generally perceived as a disease, obesity is not commonly treated as such.…”