Lee Kaplan, MD, PhD,
Director of the Obesity, Metabolism and Nutrition Institute Massachusetts General Hospital Weight Center and
ACTION study steering committee member
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Today, nearly 100 million people in the U.S. have obesity. Despite the fact that many healthcare providers and others recognize obesity as a disease that can have a significant impact on health, many people with obesity do not have access to effective care for this disorder. As a result, obesity remains substantially under-diagnosed, under-addressed and under-treated. Since multiple parties could have a role in overcoming this barrier to effective obesity care, we sought to determine and compare the perspectives and experience of three important groups – health care providers, employers, and people with obesity themselves – about obesity and its care.
As the first national study looking simultaneously at these complementary perspectives, ACTION sought to help answer several important questions:
- Given that obesity is occurring at epidemic rates, why is it not being treated? What are the barriers to effective care?
- How could public and professional attitudes contribute?
- To what degree do limitations of resources or knowledge about the disease contribute?
The ACTION study involved more than 3,000 people with obesity, 600 health care professionals, and 150 employers in the United States. What we’ve learned from the study is that there are many barriers, each of which will need to be addressed to achieve success in controlling this epidemic.
Additional quantitative data will be released upon study publication in 2017, but some notable findings about obesity care that were presented at ObesityWeek include:
• Although most people with obesity (PwO) (65%) perceived obesity as disease, most (82%) nonetheless considered weight loss to be “completely” their responsibility. This perspective appears to create a barrier to their seeking effective obesity care.
While PwO (73%) reported that they had discussed their weight with a health care provider (HCP), 36% indicated they did not seek support from their HCP for weight management.
• Another significant barrier to care revealed by the study was an inconsistent HCP-patient dialogue about weight management. Although nearly three-quarters of HCPs (72%) felt they had “responsibility to actively contribute” to patients’ weight loss efforts, only 55% of PwO reported receiving an obesity diagnosis from an HCP. And among those PwO who had discussed their weight with an HCP, only 16% of PwO reported having a follow-up appointment with their HCP. In addition, while HCPs reported being “comfortable” having obesity management conversations, such discussions and related efforts at weight management were often deprioritized due to limited time and knowledge about effective therapies.
• The study also found that despite several “serious” weight loss attempts, only 23% of PwO reported a 10% weight loss during the past three years, and only 11% described “successful” weight loss for more than one year.
MedicalResearch.com: What should readers take away from your report?
Response: These data suggest that initiatives which foster greater understanding among HCPs of their patients’ beliefs, and facilitate more robust dialogue about weight management, could positively impact obesity management efforts.
Response: MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: The ACTION study has illuminated an important role of perceptions about obesity – its causes, who is responsible for addressing it, and the likelihood of success – in creating and maintaining barriers to effective obesity care. In particular, we observed strong differences in perspective about obesity among health care providers, employers (who frequently underwrite health care costs and employee health programs) and people with obesity themselves. These differences likely prevent the type of coordinated and integrated effort essential for success in combating this disease. The next steps will be for the broader obesity community to utilize this information to determine how, individually and collectively, we can work harder and smarter to ensure that people with obesity receive care that is appropriate, compassionate and effective.
MedicalResearch.com: Is there anything else you would like to add?
Response: Obesity must be understood as a serious, often progressive disease requiring comprehensive prevention and treatment strategies to ensure that it is addressed effectively. The value of the ACTION study is that it clearly identifies several of the challenges that must be overcome, and underscores that multiple communities will need to work more collaboratively to develop and implement effective solutions.
The ACTION study, itself, results from a collaborative effort across the obesity community. It was hosted by Novo Nordisk, a company with a strong commitment to solving this problem and led by a multi-disciplinary steering committee of clinicians, scientists and advocates from The Obesity Society, the Obesity Action Coalition, and the Integrated Benefits Institute, including experts in the obesity medicine, primary care, endocrinology, physiology and nursing.
To learn more about the ACTION study, please visit www.ACTIONStudy.com.
Note: Content is Not intended as medical advice.
Please consult your health care provider regarding your specific medical condition and questions.