1492-P: Patients with Diabetes: Perspectives on Obesity Management

Abstract

In 2018 we surveyed our Endocrinology Clinic’s non-pregnant patients with diabetes, age ≥18, and BMI >30 kg/m2. Findings with 54 respondents indicated most were middle-aged, female, black, with an income <$50,000. BMI was ≥40 kg/m2 in 33.3%, 35-39.9 kg/m2 in 37%, and 30-34.9 kg/m2in 29.6%. Nearly all (95%) agreed that obesity is related to heart disease, early death, diabetes, and hypertension. Despite being obese, 62% selected overweight and 5.7% normal weight. About half (56.6%) were aware of their BMI. For why it is important to lose weight, most answered better physical function (86.8%), decreased medications (75.5%), improved self-esteem (56.6%) and physical appearance (55%). Half (52%) said they asked their health care providers (HCPs) about obesity treatment, and more (73%) recalled their HCP discussing obesity. Respondents discussed obesity with Primary Care (75.7%), Endocrinology (56.8%), Bariatric Surgery (19%), other subspecialty (10.8%), and OB/GYN (5.4%). Not discussing obesity was explained by knowing what to do (62.5%) and self-responsibility to manage weight (37.5%). None said clinic visit time was insufficient. Few (2%) reported referral to a specialty that manages obesity, anti-obesity medications (5.7%), or bariatric surgery (15%). Barriers to dietary changes were lack of time (35%), high cost (41%), knowledge (25%), or motivation (22%). Barriers to exercise were lack of time (47%) or inability to exercise due to health problems (27%). Barriers to anti-obesity medications included lack of knowledge (43%) and concern with side effects (29%). Barriers to bariatric surgery included risk of complications (35.3%), expense (17.6%), and lack of knowledge (15.7%). Barriers to initiating weight loss were a preference for unhealthy food (52.8%) and lack of exercise (67.9%). These findings reveal an excellent awareness of obesity as a health problem and the need for improved knowledge and discussion on anti-obesity medications and bariatric surgery. Disclosure S. Huq: None. S. Todkar: None. S. Lahiri: None.