There is no international consensus on which healthcare group has prime responsibility for obesity treatment. In addition, education and training vary between countries. To investigate potential barriers to weight loss discussions, we examined the attitudes of healthcare professionals (HCPs) who considered themselves to be obesity experts compared with non-experts using data from the ACTION-IO study (NCT03584191).


HCPs from 11 countries completed an online survey. HCPs were considered obesity experts if they stated that they worked in an obesity service clinic or if they considered themselves to be an expert in obesity/weight loss management.


The survey was completed by 2,785 HCPs; 1,461 (52%) were obesity experts and 1,324 (48%) were non-experts. Notably, only 63% of obesity experts and 44% of non-experts reported being very or extremely comfortable with having weight discussions with patients. The top reasons for not discussing weight with a patient were similar in both groups and included lack of patient interest (obesity experts 72%; non-experts 70%) or motivation (70%; 67%) for weight loss, more important health issues to discuss (47%; 47%), or absence of weight-related complications (41%; 35%). Fewer obesity experts cited insufficient appointment time as a reason for not discussing weight (48%) than non-experts (61%). Criteria for initiating a weight management conversation included presence of obesity-related complications (73%; 78%), body mass index (75%; 70%), and increased weight (41%; 40%).


Major barriers to initiating weight discussions for both obesity experts and non-experts include discomfort with such conversations, prioritisation of other health issues, attitudes regarding the interest or motivation of patients for weight loss, and insufficient appointment time. These data suggest that both obesity experts and non-experts could benefit from training to challenge their perceptions and attitudes towards people with obesity.