Background

Treatment guidelines in obesity typically recommend lifestyle interventions initially, with addition of adjunctive therapy if a clinically meaningful weight loss is not reached and/or maintained, or for severe cases of obesity and those with type 2 diabetes. We present data on the perceptions and attitudes of people with obesity (PwO) and healthcare professionals (HCPs) towards obesity management from the ACTION-IO study (NCT03584191).

Methods

An online survey was completed by PwO and HCPs in 11 countries. Both groups were asked about their attitudes regarding lifestyle interventions, anti-obesity medications and bariatric surgery.

Results

A total of 14,502 PwO and 2,785 HCPs completed the survey. Although most PwO (68%) and HCPs (88%) agreed that obesity is a chronic disease, 72% of PwO stated they preferred to lose weight on their own than use weight loss medication. Both PwO (80%) and HCPs (75%) preferred diet and exercise alone over surgery. Medications and surgery were only viewed as more effective than other treatment options by 41% and 31% of PwO and 30% and 51% of HCPs, respectively. Both groups reported concerns about the side effects of medications (68% PwO, 65% HCPs) and safety of surgery (68% PwO, 70% HCPs). Cost was reported as a barrier for patient use of medications and surgery by 47% and 51% of PwO and 55% and 60% of HCPs, respectively. Almost one third of HCPs (29%) said they don’t know enough about prescription weight loss medications to feel comfortable prescribing them.

Conclusions

Both PwO and HCPs favour lifestyle changes alone as the preferred management strategy over lifestyle changes combined with medications and/or surgery, with concern about the efficacy, safety, and cost of both these adjunctive therapies. These data highlight a misalignment between the acknowledgment of obesity as a chronic disease and the attitudes of both PwO and HCPs towards the use of anti-obesity medications and bariatric surgery, which could be barriers to effective obesity management.