Abstract
PurposeDespite the increasing prevalence of obesity in Italy, it remains largely underdiagnosed and undertreated. We aimed to identify the perceptions, attitudes, behaviours and barriers to effective obesity care among people with obesity (PwO) and healthcare professionals (HCPs) in Italy.MethodsThe ACTION-IO study was an online cross-sectional survey conducted in 11 countries from June to October 2018. Findings from the Italian cohort are reported here.ResultsThe survey was completed by 1501 PwO and 302 HCPs in Italy. Most PwO (84%) and HCPs (77%) acknowledged the large impact of obesity on overall health. However, fewer PwO (62%) than HCPs (91%) perceived obesity as a chronic disease. Most PwO (84%) assumed full responsibility for their weight loss. A median of 3 (mean 6) years elapsed between when PwO started struggling with obesity and when they first discussed their weight with an HCP. Many PwO expressed that they liked (80%) or would like (74%) their HCPs to initiate weight management conversations, and only 3% were offended by such a conversation. For 77% of HCPs, perceiving their patients as unmotivated or disinterested in losing weight prevented them from initiating these conversations. Short appointment times were also considered a limiting factor for 40% of HCPs.ConclusionsMost PwO took complete responsibility for their own weight loss and waited considerable time before seeking help from an HCP. There is a need for improved education of both PwO and HCPs and for a more positive attitude from HCPs towards initiating weight discussions with PwO.Trial registration ClinicalTrials.gov: Awareness, Care & Treatment in Obesity Management - an International Observation (ACTION-IO). ClinicalTrials.gov: NCT03584191Level of evidenceLevel V, cross-sectional descriptive study.
Highlights
Obesity is a growing problem in most countries, including Italy
BMI body mass index, healthcare professionals (HCPs) healthcare professional, PCP primary care physician, PwO people with obesity a A physician who meets at least one of the following criteria: at least 50% of their patients are seen for obesity/weight management, or has advanced/formal training in the treatment of obesity/weight management beyond medical school, or considers themselves to be an expert in obesity/weight loss management, or works in an obesity service clinic and 37 min for HCPs
The majority of PwO and HCPs acknowledged the large impact of obesity on overall health, fewer PwO than HCPs considered obesity as a chronic disease
Summary
Based on the World Health Organization (WHO) definition, in 2015, 35.3% of Italian adults had overweight, and an additional 9.8% were affected by obesity [1]. Obesity is associated with an increased risk of morbidity [2,3,4,5] and mortality [4,5,6,7,8] because of the associated comorbidities, representing a critical public health concern. People with obesity (PwO) experience a decrease in health-related quality of life and face stigma and discrimination, causing a negative impact on their emotional and mental well-being [9]. Besides its health-related effects, obesity has a substantial socioeconomic impact. Several studies have demonstrated that obesity and the associated comorbidities give rise to
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