A call to action to inform patient‐centred approaches to obesity management: Development of a disease‐illness model

Abstract

Patient‐centred care is an essential component of high‐quality health care, shown to improve clinical outcomes and patient satisfaction, and reduce costs. While there are several authoritative models of obesity pathophysiology and treatment algorithms, a truly patient‐centred model is lacking. We describe the development of a patient‐centric obesity model. A disease‐illness framework was selected because it emphasizes each patient's unique experience while capturing biomedical aspects of the disease. Model input was obtained from an accumulation of research including contributions from experts in obesity and patient‐reported outcomes, qualitative research with adults living in the United States, and two targeted literature searches. The model places the patient with obesity at its core and links pathologic imbalances of energy intake and expenditure to environmental, sociodemographic, psychological, behavioural, physiological and medical health determinants. It highlights relationships between obesity signs and symptoms, comorbid conditions, impacts on health‐related quality of life, and some barriers to obesity management that must be considered to attain better outcomes. Providers need to evaluate patients holistically, understand what changes each patient is motivated to make, and recognize what challenges might impede weight reduction, improvements in comorbid conditions, signs and symptoms, and health‐related quality of life before pursuing individualized treatment goals. Patients living with obesity who do lose weight perceive benefits beyond weight loss. Ideally, this model will increase awareness of the complex, heterogeneous impacts of obesity on patients' well‐being and recognition of obesity as a chronic disease, and prompt a call to action among stakeholders to improve quality of care.

<p>Adult Obesity and Health-Related Quality of Life, Patient Activation, Work Productivity, and Weight Loss Behaviors in the United States</p>

“…Each individual's experience living with obesity is unique, and individuals may perceive different negative impacts associated with this disease such as impaired physical, emotional, and social functioning as well as poor self-image and selfesteem. 1 Physiological, psychological and behavioral factors contributing to obesity are also consequences of this disease highlighting the complexity of the illness. Therefore, there is a need to better understand how obesity impacts the way people feel and function, including changes in hunger and appetite control, physical function, and social, mental, and emotional well-being.…”

“…Therefore, there is a need to better understand how obesity impacts the way people feel and function, including changes in hunger and appetite control, physical function, and social, mental, and emotional well-being. 1 It is generally believed that people with severe obesity experience greater negative impacts on health-related quality of life (HRQoL), but the experience of obesity may also be impacted by other demographic characteristics and comorbid conditions. This analysis aimed to generate further insights into how obesity affects daily life by examining HRQoL, patient engagement with health care, work productivity, and weight loss behaviors in US adults by age, gender, and type 2 diabetes mellitus (T2DM) status.…”

A novel patient-reported outcome monitoring with clinical feedback system in bariatric surgery care: study protocol, design and plan for evaluation

“…As obesity is considered a complex chronic disease, and the positive effects of bariatric surgery go beyond weight loss in itself, a patientcentred model for follow-up is recommended. 39 Ultimately, using PRO/CFS in clinical consultations may lead to improvements in patients' mental health and HRQOL after bariatric surgery.…”

Cirugía postbariátrica: el último eslabón en el protocolo de cirugía metabólica

“…Cirugía postbariátrica: el último eslabón en el protocolo de cirugía metabólica dades cardiovasculares y cáncer. 3 En décadas recientes se ha observado un incremento dramático en la prevalencia de obesidad en el mundo. En México, el 36.3% de los adolescentes y 72.5% de los adultos padecen sobrepeso y obesidad, 4 lo que nos posiciona como uno de los países más obesos.…”