Obesity Attention, Awareness Low in Both Clinicians and Patients

Nutrition advice. Nutritionist advising an obese man on how to eat a more balanced diet.
Study results found that clinicians paid low attention to obesity treatment and patients commonly underestimated the cardiometabolic complications of obesity.

Study results published in Obesity Medicine reveal doctors’ low attention to obesity treatment and patients’ underestimation of the possible cardiometabolic complications of obesity.

Obesity is highly prevalent in the adult population, and currently, there are nonpharmacologic, pharmacologic, and surgical treatment options for obesity. In the current study, the goal was to analyze obesity treatment specifics in patients with obesity and patients’ adherence to recommended treatments.

The researchers used data from patients’ interviews within the PROFILE registry, which includes patients with chronic ischemic disease, hypertensive disease, and/or cardiovascular risk factors, who are receiving treatment at a specialized cardiology department in a scientific center.

Of 347 patients with obesity (body mass index ≥30 kg/m2), 305 were interviewed about obesity care and awareness (mean age, 63.9±11.3 years; 167 women). Class I obesity (body mass index 30.0-34.9 kg/m2) was diagnosed in most patients (213 patients; 69.8%), followed by class II obesity (63 patients; 20.7%) and class III obesity (29 patients; 9.5%).

While 231 patients (75.7%) agreed that being overweight was bad for their health, only 81 of the 305 participants (26.6%) with diagnosed obesity accepted having this disease; 189 patients (62%) considered themselves overweight and 35 patients (11.5%) believed their body weight was in the normal range.

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Physicians in outpatient clinics paid attention to the issue of obesity in 83.6% of cases (255 of 305 patients), with recommendations for management of obesity given to 80.7% of patients (n=246). In most cases, the recommendations included reducing calorie intake (79.3%) or increasing physical activity (63.6%). Medications were prescribed very rarely and were recommended for 37 patients (12.1%); surgical treatment was recommended for 3 patients (1%).

Most of the patients had attempted losing weight, most often by adjusting their diet (78%) or increasing physical activity (50.2%). Only 10.2% of patients used medications, and none had undergone surgical treatment.

The researchers acknowledged several limitations of the study, including the cross-sectional observational design, small sample size, and the use of a questionnaire that had not been validated.

“Interviewing of patients with high risk [for cardiovascular disease] and obesity within the PROFILE registry revealed patients’ underestimation of their obesity-related cardiometabolic complications and doctors’ low attention to the problem of obesity treatment. Even when diet therapy and other non-pharmacological methods of treatment are inefficient, anti-obesity drug [treatments] are prescribed to patients very rarely,” concluded the researchers.

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Martsevich SY, Lukina YV, Lerman OV, Kutishenko NP, Semenova YV. Obesity treatment and adherence to doctors′ recommendations in patients with cardiovascular diseases and/or cardiovascular disease risk factors (results of patients’ interviews within the outpatient registry «PROFILE»). Obes Med. 2019;15:100119.