Boden Institute, Charles Perkins Centre, University of Sydney, Sydney, Australia.
Obesity Research Center and Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Diabetes Obes Metab. 2019 Aug;21(8):1914-1924. doi: 10.1111/dom.13752. Epub 2019 May 3.
Despite increased recognition as a chronic disease, obesity remains greatly underdiagnosed and undertreated. We aimed to identify international perceptions, attitudes, behaviours and barriers to effective obesity care in people with obesity (PwO) and healthcare professionals (HCPs).
An online survey was conducted in 11 countries. Participants were adults with obesity and HCPs who were primarily concerned with direct patient care.
A total of 14 502 PwO and 2785 HCPs completed the survey. Most PwO (68%) and HCPs (88%) agreed that obesity is a disease. However, 81% of PwO assumed complete responsibility for their own weight loss and only 44% of HCPs agreed that genetics were a barrier. There was a median of three (mean, six) years between the time PwO began struggling with excess weight or obesity and when they first discussed their weight with an HCP. Many PwO were concerned about the impact of excess weight on health (46%) and were motivated to lose weight (48%). Most PwO (68%) would like their HCP to initiate a conversation about weight and only 3% were offended by such a conversation. Among HCPs, belief that patients have little interest in or motivation for weight management may constitute a barrier for weight management conversations. When discussed, HCPs typically recommended lifestyle changes; however, more referrals and follow-up appointments are required.
Our international dataset reveals a need to increase understanding of obesity and improve education concerning its physiological basis and clinical management. Realization that PwO are motivated to lose weight offers an opportunity for HCPs to initiate earlier weight management conversations.
尽管肥胖已被广泛认为是一种慢性疾病，但它的诊断率仍然很低，治疗也不足。本研究旨在了解肥胖患者（PwO）和医疗保健专业人员（HCPs）对肥胖有效管理的国际认知、态度、行为和障碍。
在 11 个国家进行了在线调查。参与者为肥胖患者和主要关注直接患者护理的 HCPs。
共有 14502 名肥胖患者和 2785 名 HCPs 完成了调查。大多数 PwO（68%）和 HCPs（88%）认为肥胖是一种疾病。然而，81%的 PwO 认为自己应该对自己的减肥负责，只有 44%的 HCPs 认为遗传是一个障碍。PwO 开始与超重或肥胖作斗争到他们第一次与 HCP 讨论体重的时间中位数为三年（平均六年）。许多 PwO 担心超重对健康的影响（46%），并希望减肥（48%）。大多数 PwO（68%）希望他们的 HCP 主动讨论体重问题，只有 3%的人对此感到反感。在 HCPs 中，认为患者对体重管理几乎没有兴趣或动力的信念可能构成体重管理对话的障碍。当讨论到体重问题时，HCPs 通常建议进行生活方式改变；然而，还需要更多的转诊和随访预约。
我们的国际数据集显示，需要提高对肥胖的认识，并加强对其生理基础和临床管理的教育。认识到 PwO 有减肥的动力，为 HCPs 提供了更早开始体重管理对话的机会。
