Misalignment among adolescents living with obesity, caregivers, and healthcare professionals: ACTION Teens global survey study

Abstract

Summary Background There is limited evidence regarding the experiences, challenges, and needs of adolescents living with obesity (ALwO), their caregivers, and healthcare professionals (HCPs). Objectives The cross‐sectional, survey‐based global ACTION Teens study aimed to identify perceptions, attitudes, behaviours, and barriers to effective obesity care among ALwO, caregivers of ALwO, and HCPs. Methods ALwO (aged 12 to <18 years; N = 5275), caregivers (N = 5389), and HCPs treating ALwO (N = 2323) from 10 countries completed an online survey (August–December 2021). Results Most ALwO perceived their weight as above normal (76% vs. 66% of caregivers), were worried about its impact on their health (85% vs. 80% of caregivers), and recently made a weight loss attempt (58%). While 45% of caregivers believed ALwO would slim down with age, only 24% of HCPs agreed. Most commonly reported weight loss motivators for ALwO were wanting to be more fit/in better shape according to ALwO (40%) and caregivers (32%), and improved confidence/social life according to HCPs (69%). ALwO weight loss barriers included lack of hunger control (most commonly reported by ALwO/caregivers), lack of motivation, unhealthy eating habits (most commonly agreed by HCPs), and lack of exercise. Conclusions Misalignment between ALwO, caregivers, and HCPs—including caregivers' underestimation of the impact of obesity on ALwO and HCPs' misperception of key motivators/barriers for weight loss—suggests a need for improved communication and education.

Pharmacological interventions for the management of children and adolescents living with obesity—An update of a Cochrane systematic review with meta‐analyses

“…The review findings support previous systematic reviews and meta-analyses. [74][75][76][77][78][79][80][81][82] The review is unique in that it covers the following critical features: it is the most comprehensive review because it includes all drugs used to treat children and adolescents living with obesity (regardless of regulatory approval), includes psychosocial outcomes that are prioritized by these young people and their parents, [17][18][19]22 focuses on longer term studies (6 months from baseline), which reflect a move towards treating obesity as a chronic and relapsing disease, and examines multiple sources of heterogeneity.…”

“…13 The outcomes of interest were broadened and informed by recent evidence on patient-reported outcomes in order to reflect a person-centred approach, which focusses on the needs of children and adolescents living with obesity. [17][18][19]…”

“…We followed the methods of the Cochrane review 12 but broadened the outcomes of interest and assessed the certainty of evidence using current guidance by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group 13 . The outcomes of interest were broadened and informed by recent evidence on patient‐reported outcomes in order to reflect a person‐centred approach, which focusses on the needs of children and adolescents living with obesity 17–19 …”

“…We did not exclude any of the outcomes from the Cochrane review; we were aware of the need to present more than one continuous BMI metric 21 and selected additional outcomes based on evidence from studies that investigated the importance of outcomes according to adolescents living with obesity, healthcare providers and physicians. [17][18][19]22 For each outcome category, three senior reviewers (LJE, ASK and DW) voted for their preferred choices of outcomes. From the most frequently preferred outcomes, seven outcomes were chosen for the Table 2, which was used to present the certainty of the evidence for BMI, BMI as percentage of 95th percentile (new), serious adverse events, healthrelated quality of life (HRQoL), T2DM (new), social functioning (new) and self-esteem.…”

Joint statement for assessing and managing high blood pressure in children and adolescents: Chapter 2. How to manage high blood pressure in children and adolescents

“…A motivational style has to be followed, on the part of the family and/or physician, by asking openly these types of questions: asking to know how the person feels (with unhealthy habits), what worries he/she has, what doubts he/she has regarding the new habits to change, why do they think it might be important to change his/her new habits, asking about his/her opinion about potential positive consequences of doing so, helping him/her to explore his/her ambivalences and discrepancies. The most important tool to achieve this motivational style is empathy, although others may be active and reflective listening (showing genuine and sincere interest in understanding their concerns and doubts in relation to the change), honesty, not judging or criticizing, being willing to go at the individual's pace, promoting self-efficacy (see Boxs 3 , 4 and Table 11 ) ( 35 , 36 ).…”