Gaps to bridge: Misalignment between perception, reality and actions in obesity
Gaps to bridge: Misalignment between perception, reality and actions in obesity
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DOI：
10.1111/dom.13752
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发表时间：
2019-08-01
影响因子：
5.8
通讯作者：
Halford, Jason C. G.
中科院分区：
文献类型：
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作者：
Caterson, Ian D.;Alfadda, Assim A.;Halford, Jason C. G.
目标：尽管人们越来越多地认识到肥胖是一种慢性病，但肥胖症的诊断和治疗仍然严重不足。我们的目标是确定肥胖者(PWO)和医疗保健专业人员(HCP)在有效肥胖护理方面的国际认知、态度、行为和障碍。材料与方法在11个国家开展了一项在线调查。参与者是患有肥胖症的成年人和主要关心直接患者护理的HCP。结果共有14 502名预科医生和2785名医务人员完成了调查。大多数PWO(68%)和HCP(88%)同意肥胖是一种疾病。然而，81%的PWO承担了自己减肥的全部责任，只有44%的HCP同意遗传是一种障碍。从PWO开始与超重或肥胖作斗争到他们第一次与HCP讨论自己的体重，中位数为三年(平均六年)。许多PWO担心超重对健康的影响(46%)，并有减肥的动机(48%)。大多数PWO(68%)希望他们的HCP发起关于体重的对话，只有3%的人被这样的对话冒犯。在HCP中，认为患者对体重管理缺乏兴趣或动机的想法可能会构成体重管理对话的障碍。在讨论时，HCP通常建议改变生活方式；然而，需要更多的转介和后续预约。结论我们的国际数据集显示，有必要提高对肥胖的认识，并加强对其生理基础和临床管理的教育。认识到PWO的动机是减肥，这为HCP提供了一个机会，可以开始更早的体重管理对话。
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). Materials and methods An online survey was conducted in 11 countries. Participants were adults with obesity and HCPs who were primarily concerned with direct patient care. Results A total of 14 502 PwO and 2785 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 three (mean, six) years between the time PwO began 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 in or motivation for weight management may constitute a barrier for weight management conversations. When discussed, HCPs typically recommended lifestyle changes; however, more referrals and follow-up appointments are required. Conclusions Our international dataset reveals a need to increase understanding of obesity and improve education concerning its physiological basis and clinical management. Realization that PwO are motivated to lose weight offers an opportunity for HCPs to initiate earlier weight management conversations.