Abstract

BackgroundObesity is a highly prevalent, complex, and chronic relapsing disease with a considerable unmet medical need. We aimed to identify perceptions, attitudes, behaviors, and barriers to effective obesity treatment among people with obesity (PwO) and physicians in Israel.MethodsThe ACTION-IO study was an online survey conducted in 11 countries, including Israel. Findings from the Israeli cohort are reported here. Israeli respondents were PwO (body mass index of ≥30 kg/m2 based on self-reported height and weight) and physicians primarily in direct patient care.ResultsIn total, 750 PwO and 169 physicians completed the survey in Israel. Although most PwO (70%) and physicians (95%) perceived obesity as a chronic disease, the majority of PwO assumed full responsibility for their own weight loss (88%) compared with only 19% of physicians who placed the responsibility for weight loss on their patients with obesity. Many PwO (62%) and physicians (73%) agreed that a complete change in lifestyle would be required for PwO to lose weight and felt that treatment of obesity should be a team effort between different healthcare professionals (HCPs; 80 and 90%, respectively). Dietitians were considered by 82% of physicians to be the most effective professionals in helping PwO achieve their weight loss goals. Many PwO (69%) liked that their HCP initiated weight management discussions and 68% of those who had not previously discussed their weight would like their HCP to initiate the conversation. However, among PwO who had discussed their weight with an HCP, 59% considered the discussions to be a little helpful or not at all helpful. The beliefs that patients have little interest in or motivation for losing weight were identified by physicians as the main reasons (71 and 70%, respectively) for not initiating weight management discussions.ConclusionsIn line with the ACTION-IO international study, our Israeli dataset reveals a need to improve awareness, primarily among physicians, on the physiologic basis and clinical management of obesity, including how to approach weight and weight management discussions during patient consultations.Trial registrationRegistered at ClinicalTrials.gov, NCT03584191. Data first posted on ClinicalTrials.gov: 12 July 2018 - ‘Retrospectively registered’.

Highlights

  • Obesity is a highly prevalent, complex, and chronic relapsing disease with a considerable unmet medical need

  • Whilst 73% of physicians agreed that a complete change in lifestyle would be required for people with obesity (PwO) to lose weight, 87% recognized that Healthcare professional (HCP) needed to contribute to Weight loss attempts and outcomes Most PwO (92%) had made a serious effort to lose weight on at least one occasion, with a mean number of 6 attempts (Fig. 3a)

  • Should actively contribute to their effort to lose weight. This is similar to the international results, in which 81% of PwO thought that weight loss was their sole responsibility and 26% agreed that HCPs had a responsibility to contribute to their weight loss [7]

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Summary

Introduction

Obesity is a highly prevalent, complex, and chronic relapsing disease with a considerable unmet medical need. We aimed to identify perceptions, attitudes, behaviors, and barriers to effective obesity treatment among people with obesity (PwO) and physicians in Israel. Obesity is a chronic relapsing disease with a high disease burden that is due to the associated metabolic, mechanical, malignant, mental, and monetary complications [1, 2]. Healthcare provision in Israel is managed by four Health Maintenance Organizations (HMO) [6], which have established an educated and effective primary physician care service. The HMOs offer the following options for people with obesity (PwO): dietitian counseling; lifestyle coaching; bariatric surgery; and pharmacotherapy, including phentermine, orlistat, liraglutide, and lorcaserin. Pharmacologic interventions are not currently reimbursed in the national health basket for the treatment of obesity. Further improvements to obesity care require a deeper understanding of the disease itself and identification of the gaps between current and optimal management of obesity

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