Perceptions of barriers to effective obesity management in Canada: Results from the ACTION study

Arya M Sharma, André Bélanger, Veronica Carson, Jodi Krah, Marie-France Langlois, Diana Lawlor, Suzanne Lepage, Aiden Liu, David A Macklin, Noel MacKay, Arash Pakseresht, Sue D Pedersen, Ximena Ramos Salas, Michael Vallis, Arya M Sharma, André Bélanger, Veronica Carson, Jodi Krah, Marie-France Langlois, Diana Lawlor, Suzanne Lepage, Aiden Liu, David A Macklin, Noel MacKay, Arash Pakseresht, Sue D Pedersen, Ximena Ramos Salas, Michael Vallis

Abstract

Obesity is a chronic disease with a significant and growing impact on Canadians. The "Awareness, Care and Treatment In Obesity MaNagement" (ACTION) Study investigated perceptions, attitudes and perceived barriers to obesity management among Canadian people with obesity (PwO), healthcare providers (HCPs) and employers. In this study adult PwO (body mass index ≥30 kg/m2 , based on self-reported height/weight), HCPs (physicians and allied HCPs managing PwO) and employers (≥20 employees; offering health insurance), completed online surveys between 3 August and 11 October 2017 in a cross-sectional design. Survey respondents (N = 2545) included 2000 PwO, 395 HCPs and 150 employers. Obesity was viewed as a "chronic medical condition" by most PwO (60%), HCPs (94%) and employers (71%) and deemed to have a large impact on overall health (74%, 78%, 81%, respectively). Many PwO (74%) believed weight management was their own responsibility. While PwO (55%) reportedly knew how to manage their weight, only 10% reported maintaining ≥10% weight reduction for >1 year. Despite low success rates, the most commonly reported effective long-term weight loss methods tried and/or recommended were "improvements in eating habits" (PwO 38%; HCP 63%) and "being more active" (PwO 39%; HCP 54%). PwO and HCPs reported very different perceptions of the quality and content of their interaction during obesity management discussions. These findings highlight the communication gaps and misunderstanding between PwO, HCPs and employers. This underscores the importance of, and need for, evidence-based management of obesity and a collaborative approach and understanding of the complex nature of this chronic disease.

Keywords: ACTION study; Canada; obesity management; perception.

Conflict of interest statement

A.M.S. reports personal fees from Novo Nordisk, during the conduct of the study; personal fees from Valeant, outside the submitted work. A.B. reports personal fees from Amgen, AstraZeneca, Janssen, Merck Frosst, Novo Nordisk, Purdue, Pfizer, during the conduct of the study; personal fees from Amgen, Novo Nordisk, Paladin, Purdue, Pfizer, outside the submitted work. A.L., A.P. and V.C. report being employed by Novo Nordisk Canada Inc. J.K. and D.L. report personal fees from Novo Nordisk, during the conduct of the study. M.‐F.L. reports personal fees from Novo Nordisk during the conduct of the study; personal fees from Novo Nordisk Canada and Valeant Canada and grants from Merck Canada, outside the submitted work. S.L. reports personal fees from Novo Nordisk Canada, during the conduct of the study; employment income from Weight Watchers, outside the submitted work. D.A.M. reports personal fees from Novo Nordisk, during the conduct of the study; personal fees from Novo Nordisk, personal fees from Valeant, outside the submitted work. N.M. reports personal fees from Novo Nordisk, during the conduct of the study. S.D.P. reports personal fees and non‐financial support from Novo Nordisk, during the conduct of the study; personal fees and non‐financial support from Novo Nordisk, grants, personal fees and non‐financial support from Eli Lilly, personal fees and non‐financial support from Merck, personal fees and non‐financial support from Valeant, grants, personal fees and non‐financial support from AstraZeneca, grants, personal fees and non‐financial support from Sanofi, outside the submitted work. X.R.S. has nothing to disclose. M.V. reports personal fees from Novo Nordisk, during the conduct of the study; personal fees from CSL Behring, Merck, Novo Nordisk, Pfizer, Sanofi, Valeant, outside the submitted work.

© 2019 The Authors. Clinical Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

Figures

Figure 1
Figure 1
Methods reported by PwO and HCPs as effective for long‐term weight management. Percentages represent the proportion of respondents who tried (from those PwO who had made at least one serious WL effort) or recommended (HCPs) that WL method and found it to be effective, based on their personal criteria, for long‐term weight management. *0.07% of PwO and †6% of HCPs selected “other.” HCP, healthcare provider; PwO, people with obesity; WL, weight loss
Figure 2
Figure 2
Reasons for not discussing weight management, as reported by PwO and HCPs. Respondents were asked to select up to five “top” reasons from a list provided, or enter a text response. Questions for PwO and HCPs were worded slightly differently, as required, and HCPs were asked an additional question: “I do not get financial compensation for treating obesity” (data not shown). HCP, healthcare provider; PwO, people with obesity
Figure 3
Figure 3
Perceptions regarding interactions between PwO and HCPs, as reported by PwO and HCPs. Percentages indicate number of respondents selecting the polling option from the provided list. Questions for PwO and HCPs were worded slightly differently, as required. HCP, healthcare provider; PwO, people with obesity

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