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Cited by 210Obesity and Health PracticesObesity, Physical Activity, DietEating Disorders and Behaviors

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

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Caterson, Ian D., Alfadda, Assim A, Auerbach, Pernille, Coutinho, Walmir, Cuevas, Ada, Dicker, Dror, Hughes, Carly, Iwabu, Masato +9 more·2019·Diabetes, Obesity and Metabolism
DOI 10.1111/dom.13752PMC PMC6767048
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Abstract

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.

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  • These attitudes and behaviours towards obesity and its care appear to be widely shared by people with obesity across different regions globally.

    “These attitudes and behaviours towards obesity and its care appear to be widely shared by people with obesity across different regions globally.60–62”

    From Definition and diagnostic criteria of clinical obesity (2025) · cites this paper as [60]

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Authors
Caterson, I. D., Alfadda, A. A., Auerbach, P., Coutinho, W., Cuevas, A., Dicker, D., Hughes, C., Iwabu, M., Kang, J., Nawar, R., Reynoso, R., Rhee, N., Rigas, G., Salvador, J., Sbraccia, P., Vázquez‐Velázquez, V., & Halford, J. C. G.
Affiliations
  • The University of Sydney (AU)
  • King Saud University (SA)
  • Novo Nordisk (Denmark) (DK)
  • Pontifícia Universidade Católica do Rio de Janeiro (BR)
  • Clínica Las Condes (CL)
  • Tel Aviv University (IL)
  • University of East Anglia (GB)
  • The University of Tokyo (JP)
  • Kangbuk Samsung Hospital (KR)
  • Dubai Health Authority (AE)
  • Novo Nordisk (Switzerland) (CH)
  • UNSW Sydney (AU)
  • Instituto de Salud Carlos III (ES)
  • University of Rome Tor Vergata (IT)
  • Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX)
  • University of Liverpool (GB)
Corresponding author
Caterson, Ian D.
ORCID
Venue
Diabetes, Obesity and Metabolism
Publisher
Wiley
Published
2019-05-03
Volume
21
Issue
8
Pages
1914-1924
ISSN
  • 1462-8902 (ISSN-L)
  • 1463-1326
DOI
10.1111/dom.13752
PMC
PMC6767048
OpenAlex
W2943653847
Cited by
210
References
7
Citations by year
2026: 39 · 2025: 39 · 2024: 38 · 2023: 25 · 2022: 17 · 2021: 25 · 2020: 24 · 2019: 2
FWCI
31.56
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Obesity and Metabolism (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • UEA Digital Repository (University of East Anglia) (acceptedVersion)
  • Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion, other-oa)
  • Deposito Adademico Digital Universidad De Navarra (University of Navarra) (submittedVersion, cc-by-nc)
Funders
Novo Nordisk
Topics
  • Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Keywords
obesity, obesity care, underdiagnosis, undertreatment, clinician attitudes, patient perspectives, barriers to weight loss, patient motivation
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Attitude of Health Personnel, Attitude to Health, Chronic Disease, Cross-Sectional Studies, Female, Health Personnel, Humans, Male, Middle Aged, Motivation, Obesity, Perception, Surveys and Questionnaires, Young Adult

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