Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.
MedFit Proactive Healthcare, Blackrock, Dublin, Ireland.
Ir J Med Sci. 2021 Feb;190(1):163-168. doi: 10.1007/s11845-020-02319-y. Epub 2020 Jul 21.
In patients with obesity (PwO) and heath care providers (HcPs), there appears to exist a discrepancy between recognition of obesity as a disease and the underlying biology of the disease. This is evident when considering PwO and HcPs appear to agree obesity is a disease but position lifestyle related factors as the main barriers to treatment with "eat less and move more" considered the best treatment approach. This does not align with current evidence regarding obesity treatments and the underlying pathophysiology. An understanding of PwO beliefs and perceptions may facilitate improved communication strategies with regard to the underlying pathophysiology of obesity as a disease. This has the potential to lead to improvements in both prevention and treatment strategies. Therefore, we evaluated PwO beliefs and perceptions of obesity as a disease, obesity causation and obesity treatment recorded during clinical evaluation.
As part of usual clinical practice we record 9 items to investigate beliefs and perceptions of obesity in PwO. We used a clinical audit to determine how frequently this information was formally recorded and to explore the association between beliefs and perceptions.
The information was formally recorded in the patients' chart in 52 out of 108 patients (49%) who were part of an intensive lifestyle and medication program between 2018 and 2020. We found PwO tend to agree that obesity is a disease and that weight loss maintenance is dependent on willpower. A strong tendency towards agreement was present for the statement exercise is essential for weight loss. For the statement exercise is as effective as diet alone for weight loss, a tendency towards disagreement was present. Seventy-nine percent of PwO claimed to know the recommended guidelines for exercise with average response aligning with the America College of Sports Medicine recommendations. In exploring the relationship between responses, a number of significant associations were present which may facilitate future approaches to changing the narrative around obesity as a disease and isolating specific aspects of the message that need to be focused upon for the PwO.
PwO appear to have conflicting beliefs regarding obesity as a disease and the underlying biology. This has the potential to hinder attempts to treat the disease via lifestyle intervention and may also reduce likelihood to consider alternative treatment options. These beliefs and perceptions need to be explored further, along with those of HcPs, policy makers and the general public. Collectively this may facilitate changing the narrative around obesity as a disease and positively impact both the prevention and treatment of this disease.
在肥胖患者（PwO）和医疗保健提供者（HcPs）中，人们似乎对肥胖作为一种疾病的认识与其疾病的潜在生物学之间存在差异。当考虑到 PwO 和 HcPs 似乎都认为肥胖是一种疾病，但将与生活方式相关的因素视为治疗的主要障碍，而“少吃多动”被认为是最佳治疗方法时，这一点就很明显。这与目前关于肥胖治疗和潜在病理生理学的证据不一致。了解 PwO 的信念和观念，可能有助于改善对肥胖作为一种疾病的潜在病理生理学的沟通策略。这有可能改善预防和治疗策略。因此，我们评估了 PwO 对肥胖作为一种疾病、肥胖的病因和肥胖治疗的信念和观念，这些观念是在临床评估期间记录的。
作为常规临床实践的一部分，我们记录了 9 项调查肥胖患者的信念和观念的项目。我们使用临床审计来确定这些信息是否被正式记录，并探讨信念和观念之间的关联。
在 2018 年至 2020 年期间参加强化生活方式和药物治疗计划的 108 名患者中，有 52 名（49%）患者的信息被正式记录在患者的图表中。我们发现 PwO 倾向于同意肥胖是一种疾病，并且体重维持依赖于意志力。对于“运动对于减肥至关重要”的说法，存在强烈的同意倾向。对于“运动与单独节食一样有效减肥”的说法，存在不同意的倾向。79%的 PwO 声称了解运动的推荐指南，平均反应与美国运动医学学院的建议一致。在探索反应之间的关系时，存在一些显著的关联，这可能有助于未来改变肥胖作为一种疾病的叙述，并确定需要关注的特定方面的信息，以便为 PwO 提供信息。
PwO 似乎对肥胖作为一种疾病及其潜在生物学存在相互矛盾的信念。这可能会阻碍通过生活方式干预来治疗这种疾病的尝试，也可能降低他们考虑替代治疗方案的可能性。这些信念和观念需要进一步探讨，同时还需要探讨 HcPs、政策制定者和公众的信念和观念。这可能有助于改变肥胖作为一种疾病的叙述，并积极影响这种疾病的预防和治疗。
