Gaps to bridge: Misalignment between perception, reality and actions in obesity

Ian D. Caterson*, Assim A. Alfadda, Pernille Auerbach, Walmir Coutinho, Ada Cuevas, Dror Dicker, Carly Hughes, Masato Iwabu, Jae Heon Kang, Rita Nawar, Ricardo Reynoso, Nicolai Rhee, Georgia Rigas, Javier Salvador, Paolo Sbraccia, Verónica Vázquez-Velázquez, Jason C.G. Halford

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)1914-1924
Number of pages11
JournalDiabetes, Obesity and Metabolism
Issue number8
StatePublished - Aug 2019


  • attitudes
  • barriers
  • international
  • obesity
  • perceptions


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