Department of Clinical Sciences in Malmö, Lund University, Internal Medicine Research Group, Jan Waldenströms gata 15, 5th floor, Skåne University Hospital, S-20502, Malmö, Sweden.
Department of Research and Development, Region Kronoberg, Växjö, Sweden.
BMC Prim Care. 2022 Aug 16;23(1):208. doi: 10.1186/s12875-022-01811-x.
Obesity is a chronic disease with increasing prevalence. We aimed to explore primary care physicians' knowledge and attitudes about obesity and how knowledge and attitudes are associated with confidence and adherence to obesity guidelines and barriers to obesity treatment.
A questionnaire survey was sent by e-mail to 1642 primary care physicians in four regions in Sweden. The survey focused on the physicians' knowledge, attitudes towards obesity, confidence in obesity management, adherence to obesity guidelines and barriers to optimal care. We created different statistical indices for knowledge, attitudes and adherence. To analyse the correlation between these indices, we used linear regression analyses.
Replies from 235 primary care physicians yielded a response rate of 14.3%. Most physicians answered correctly that obesity is a disease (91%), that obesity regulation sits in the hypothalamus (70%) and that obesity is due to disorders of appetite regulation (69%). However, 44% of the physicians thought that the most effective weight reduction method for severe obesity was lifestyle changes; 47% believed that obesity is due to lack of self-control, 14% mentioned lack of motivation and 22% stated laziness. Although 97% believed that physicians can help individuals with obesity and 56% suggested that obesity treatment should be prioritised, 87% of the physicians expressed that losing weight is the patients' responsibility. There was a positive association between higher knowledge and better adherence to obesity guidelines (B = 0.07, CI 0.02-0.12, p-value = 0.005) and feeling confident to suggest medication (p < 0.001) or bariatric surgery (p = 0.002). While 99% of the physicians felt confident to discuss lifestyle changes, 67% and 81% were confident to suggest medication or bariatric surgery, respectively. Respondents perceived that the greatest barrier in obesity management was lack of time (69%) and resources (49%).
There was a positive association between Swedish primary care physicians' knowledge and adherence to obesity guidelines and being more confident to suggest obesity treatment. Yet, many physicians had an ambivalent attitude towards obesity management.
肥胖是一种患病率不断上升的慢性疾病。本研究旨在探讨初级保健医生对肥胖的认知和态度，以及认知和态度与对肥胖管理的信心、对肥胖管理指南的遵循情况以及肥胖治疗的障碍之间的关系。
我们通过电子邮件向瑞典四个地区的 1642 名初级保健医生发送了一份调查问卷。该调查问卷主要关注医生的肥胖知识、肥胖态度、对肥胖管理的信心、对肥胖管理指南的遵循情况以及肥胖治疗的障碍。我们为知识、态度和遵循情况创建了不同的统计指标。为了分析这些指标之间的相关性，我们使用了线性回归分析。
235 名初级保健医生的回复得出的回复率为 14.3%。大多数医生正确回答肥胖是一种疾病（91%）、肥胖调节位于下丘脑（70%）以及肥胖是由于食欲调节紊乱（69%）。然而，44%的医生认为严重肥胖的最有效减肥方法是生活方式改变；47%的医生认为肥胖是由于缺乏自我控制，14%的医生提到缺乏动力，22%的医生表示懒惰。尽管 97%的医生认为医生可以帮助肥胖患者，56%的医生认为肥胖治疗应优先考虑，但 87%的医生表示减肥是患者的责任。较高的知识水平与更好地遵循肥胖管理指南之间存在正相关（B=0.07，CI 0.02-0.12，p 值=0.005），与更有信心建议药物治疗（p<0.001）或减肥手术（p=0.002）之间也存在正相关。尽管 99%的医生有信心讨论生活方式改变，但分别有 67%和 81%的医生有信心建议药物治疗或减肥手术。受访者认为肥胖管理的最大障碍是缺乏时间（69%）和资源（49%）。
瑞典初级保健医生的肥胖知识与对肥胖管理指南的遵循情况呈正相关，且他们更有信心建议肥胖治疗。然而，许多医生对肥胖管理的态度存在矛盾。
