Endocrinology Unit, Regina Apostolorum Hospital, Rome, Italy.
Endocrinology and Metabolism - Regina Apostolorum Hospital, Roma, Italy.
Front Endocrinol (Lausanne). 2023 Jan 17;13:1061511. doi: 10.3389/fendo.2022.1061511. eCollection 2022.
Obesity is a global pandemic and is cause of serious concern in all regions of the world. It is important to raise the attention of health care professionals in order to provide early treatment of patients with obesity. Obesity management, however, varies greatly amongst endocrinologists with respect to attitudes to diagnosis and treatment. Aim of this study was to identify practices and needs of Italian endocrinologists with respect to people with obesity.
In this study, all members of the Italian Association of Clinical Endocrinologists (AME) were invited to participate in a web-based survey concerning the management of obesity.
The response rate was 24.1% (542/2248). Nutritional and obesity problems were reported as major areas of interest by 29.4% of the participants. A large proportion of patients seeking an endocrine consultation for other reasons are affected by obesity, but one in five respondents addressed the issue in 25% or less of the cases, while one in three always dealt with the problem. Obesity was managed personally/within a dedicated team by 42.6% of participants, while the remainders referred the patient to a dietician/nutritionist or a 2nd level center for obesity therapy. Metformin was used in a median of 30% of the patients (Interquartile range: 10-50) and liraglutide in 10% of the cases (IQR 0-30), while orlistat (median 0%; IQR 0-10) and naltrexone/bupropion (median 0%; IQR 0-5) were seldom prescribed. Cost of therapy was considered as the major limitation to the use of anti-obesity drugs, affecting adherence to long-term treatment. According to 41.9% of respondents, psychological support should be offered to all patients with obesity. Finally, 56% of participants believe that the availability of new drugs will increase the number of patients candidate to drug therapy.
In conclusion, it is of primary importance to raise the awareness of endocrinologists towards the problem of obesity and increase their confidence in managing this pathological condition.
肥胖是一种全球性的流行疾病，也是世界各地区严重关切的问题。提高医疗保健专业人员的认识非常重要，以便为肥胖患者提供早期治疗。然而，内分泌学家在肥胖症的诊断和治疗态度方面存在很大差异。本研究旨在确定意大利内分泌学家在肥胖患者管理方面的做法和需求。
在这项研究中，邀请了意大利临床内分泌学家协会（AME）的所有成员参加一项关于肥胖管理的网络调查。
应答率为 24.1%（542/2248）。29.4%的参与者表示营养和肥胖问题是他们主要关注的领域。有相当一部分因其他原因寻求内分泌咨询的患者患有肥胖症，但五分之一的受访者在 25%或更少的情况下处理这个问题，而三分之一的受访者总是处理这个问题。42.6%的参与者亲自/在专门的团队中管理肥胖症，而其余的人将患者转介给营养师/营养师或二级肥胖症治疗中心。二甲双胍在中位数 30%的患者中使用（四分位距：10-50），利拉鲁肽在 10%的病例中使用（四分位距：0-30），而奥利司他（中位数 0%；四分位距 0-10）和纳曲酮/安非他酮（中位数 0%；四分位距 0-5）很少被开处。治疗费用被认为是限制使用抗肥胖药物的主要因素，这会影响到长期治疗的依从性。根据 41.9%的受访者的说法，应该向所有肥胖患者提供心理支持。最后，56%的参与者认为新药物的可用性将增加适合药物治疗的患者数量。
总之，提高内分泌学家对肥胖问题的认识并增强他们管理这种病理状况的信心至关重要。
