Gaps to bridge: Misalignment between perception, reality and actions in obesity

Ian D Caterson, Assim A Alfadda, Pernille Auerbach, Walmir Coutinho, Ada Cuevas, Dror Dicker, Carly Hughes, Masato Iwabu, Jae-Heon Kang, Rita Nawar, Ricardo Reynoso, Nicolai Rhee, Georgia Rigas, Javier Salvador, Paolo Sbraccia, Verónica Vázquez-Velázquez, Jason C G Halford

Research output: Contribution to journalArticlepeer-review

94 Citations (Scopus)
36 Downloads (Pure)


AIMS: 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).

METHODS: An online survey was conducted in 11 countries. Participants were adults with obesity and HCPs primarily in direct patient care.

RESULTS: 14,502 PwO and 2,785 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 3 (mean 6) years between the time when PwO started 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/motivation for weight management may constitute a barrier for weight management conversations. When discussed, HCPs typically recommended lifestyle changes; but more referrals and follow-up appointments are required.

CONCLUSIONS: Our international dataset reveals a need to increase understanding of obesity and improve education on its physiological basis and clinical management. Realisation that PwO are motivated to lose weight offers an opportunity for HCPs to initiate earlier weight management conversations.

SPONSOR: Novo Nordisk. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)1914-1924
JournalDiabetes, Obesity & Metabolism
Issue number8
Early online date29 Apr 2019
Publication statusPublished - 1 Aug 2019

Cite this