Provider-patient communication about obesity is inadequate, study finds

Despite increasing urgency in the face of the number of people with obesity in the United States, many patients continue to struggle with weight loss. A new study finds key gaps in approaches to the condition among patients, providers and employers.

The results of the cross-sectional Awareness, Care and Treatment in Obesity Management (ACTION) study, published in the research journal Obesity, show that fewer than 1 out of 4 patients with obesity reported weight loss of 10% over the previous three years. Despite general agreement about the cause of obesity among patients, study authors said communication between healthcare providers and patients still is not robust enough to ensure the condition gets treated like a disease.

Recent statistics suggest that obesity rates have begun to level off, though they remain alarmingly high, and that progress could easily be undermined by a variety of factors.

The latest study shows that while people with obesity recognize they are overweight, healthcare providers generally have a better grasp of how serious the health consequences of the condition can be. Only about half of the patients with obesity surveyed connected their obesity to their future health, compared to 80% of healthcare providers. At the same time, only 17% of patients with obesity find employer wellness programs helpful in weight loss, despite largely positive perceptions of such programs among healthcare providers and employers themselves.

All groups reportedly agreed that a lack of motivation and lack of exercise formed the primary barrier to weight loss. Rather than seeing the condition as a chronic disease, however, patients apparently continue to see their weight as a personal failure and therefore are less inclined to discuss weight management with their physician.

Meanwhile, physicians also hesitate to initiate discussions, sometimes due to ingrained negative attitudes toward patients with obesity, including an increased proclivity to see patients with obesity as either too embarrassed to talk about their weight or insufficiently motivated to do anything about it. The study indicates that also contributes to low numbers of patients who receive a formal diagnosis of obesity.

“We need to fundamentally rethink obesity so that the public and healthcare community understand more about the biology, chronicity and overall health impact of this disease,” lead author Lee Kaplan, M.D., Ph.D., director of the Obesity, Metabolism and Nutrition Institute at Massachusetts General Hospital, said in a study announcement. By shining a light on the barriers to discussion, especially between patients and their healthcare providers, he hopes to find ways to bridge the existing communication gaps and generate greater progress on curbing obesity.