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

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

doi:10.1111/cob.12329

Cited by 53 publications

(108 citation statements)

References 43 publications

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“…Similarly, few PwO recognize that their HCP has a responsibility to actively contribute to their weight‐loss efforts (range, 21%‐36%) (15,16,20‐22). This is in stark contrast to the responses from HCPs; in Mexico, 92% of HCPs acknowledged their responsibility, compared with 76% to 83% of HCPs in the other ACTION‐IO cohorts (16,20‐22), 72% of HCPs in the ACTION US cohorts (14), and 78% of HCPs in the ACTION Canada cohort (15). PwO assuming full responsibility for weight management is a form of weight‐bias internalization, whereby PwO blame themselves; this is particularly concerning considering that weight stigma, including self‐directed stigma, has been shown to be harmful to mental health and is associated with exercise avoidance and unhealthy eating (23).…”

Section: Discussionmentioning

confidence: 99%

Perceptions, Attitudes, and Barriers to Obesity Care in Mexico: Data From the ACTION‐IO Study

Vázquez‐Velázquez

Laviada-Molina

García-García

et al. 2021

Obesity

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(ACTION-IO) study (ClinicalTrials.gov identifier NCT03584191) aimed to identify perceptions, attitudes, behaviors, and barriers to effective obesity care in people with obesity (PwO) and health care professionals (HCPs). This study presents the results from Mexico. Methods: An online survey was conducted. In Mexico, eligible PwO were ≥18 years of age with BMI ≥30 kg/m 2 based on self-reported height and weight. Eligible HCPs had direct patient care. Results: The survey was completed by 2,000 PwO and 400 HCPs in Mexico. Many PwO (71%) and HCPs (94%) categorized obesity as a chronic disease. Sixty-three percent of PwO felt motivated to lose weight, but many HCPs perceived that PwO were not interested in losing weight (76%) or motivated to lose weight (69%). Lack of financial means to support weight-loss efforts was a barrier for PwO (34%) to discussing weight with HCPs. Sixty-five percent of PwO had discussed weight with HCPs in the past 5 years. PwO (80%) and HCPs (89%) considered lack of exercise as the main barrier to weight loss. Few PwO (34%) had successfully lost ≥5% of their body mass over the past 3 years. Conclusions: This ACTION-IO study in Mexico identified discrepancies in the perceptions of PwO and HCPs, highlighting opportunities for further education and patient-centered approaches.

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Section: Discussionmentioning

confidence: 99%

Perceptions, Attitudes, and Barriers to Obesity Care in Mexico: Data From the ACTION‐IO Study

Vázquez‐Velázquez

Laviada-Molina

García-García

et al. 2021

Obesity

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“…In terms of what can be done to counteract these physiological factors promoting weight regain, studies have suggested that the long-term adoption of behaviors that promote reducing energy intake and increasing energy expenditure (particularly self-monitoring of weight and eating, and cognitive/psychological behaviors such as self-efficacy for weight management and self-efficacy for exercise) may help to avoid regain ( 29 , 30 ). Long-term behavior change, however, may be difficult to achieve, thus the problem of weight regain remains significant within the field of obesity.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Changes in Weight in Patients With Severe and Complicated Obesity After Completion of a Milk-Based Meal Replacement Programme

et al. 2020

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Introduction: Even with very significant short term weight loss with intensive dietary restriction, subsequent weight regain remains a challenge for most patients. We sought to assess long-term weight change in patients with obesity following completion of a 24-week milk-based meal replacement programme. Methods: We conducted a retrospective cohort study of bariatric patients who completed our milk-based meal replacement programme. This programme started with an 8-week weight loss phase, followed by weight stabilization (8 weeks) and weight maintenance (8 weeks) phases, after which patients were followed up in the bariatric outpatient clinics. A paired sample t-test was used to compare mean differences in weight at the start and the end of the programme and at follow-up. Linear regression was used to identify predictors of weight regain. Results: In total, 78 patients had long term follow-up data at a mean of 34.4 ± 19.8 months after the start of the milk diet and were included in this analysis. Mean body mass index at baseline was 50.5 ± 7.6 kg m −2 , 41 (52.6%) were female and the mean age was 51.6 ± 12.0 (range 18.0-71.5) years. Weight decreased from144 ± 26 kg at the start of the milk diet to 121.2 ± 24 kg at completion (P < 0.001), with a non-significant trend upwards in the 1st and 2nd years of follow-up to 129.0 ± 27.7 (P = 0.07 compared to nadir) and 123.4 ± 29.0kg (P = 0.17), respectively. Although regains in the 3rd and 4th follow-up years were substantial to 131.0 ± 22.3 (P < 0.001), and 139.8 ± 35.4 kg (P < 0.001), there was still a moderate net weight loss of 4.7 [9.5, 0.21] and 7.0 [13.9, 0.26] kg (both P = 0.04) between the start and the 3rd and 4th follow-up years, respectively. The amount of weight regain was inversely associated with weight loss at completion of the programme, age, and directly associated with the duration of follow up in months (β = 1.2 [0.46, 1.9] P = 0.002). Abdalgwad et al. Long-Term Effect of Milk-Based Meal Replacement Conclusion: In patients with severe obesity who completed a milk-based meal replacement programme and lost a large amount of weight, over 4 years of follow-up there was very substantial weight regain. Greater initial weight loss and older age were associated with less subsequent weight regain.

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“…The survey was conducted by a third-party vendor (KJT Group [Honeoye Falls, NY, USA]); Israeli responses were collected between August 27, 2018 and October 22, 2018. The ACTION-IO study was designed by the study steering committee (including medical doctors employed by Novo Nordisk), with support from KJT Group, and based on ACTION US [ 8 ] and ACTION Canada [ 9 ]. To avoid bias, questionnaire items were carefully phrased and presented in the same order for each respondent and items in a list were displayed alphabetically, categorically, chronologically or randomly, as relevant for each response set.…”

Section: Methodsmentioning

confidence: 99%

ACTION-IO as a platform to understand differences in perceptions, attitudes, and behaviors of people with obesity and physicians across countries – the Israeli experience

Dicker

Kornboim

Bachrach

et al. 2020

Isr J Health Policy Res

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Background Obesity is a highly prevalent, complex, and chronic relapsing disease with a considerable unmet medical need. We aimed to identify perceptions, attitudes, behaviors, and barriers to effective obesity treatment among people with obesity (PwO) and physicians in Israel. Methods The ACTION-IO study was an online survey conducted in 11 countries, including Israel. Findings from the Israeli cohort are reported here. Israeli respondents were PwO (body mass index of ≥30 kg/m2 based on self-reported height and weight) and physicians primarily in direct patient care. Results In total, 750 PwO and 169 physicians completed the survey in Israel. Although most PwO (70%) and physicians (95%) perceived obesity as a chronic disease, the majority of PwO assumed full responsibility for their own weight loss (88%) compared with only 19% of physicians who placed the responsibility for weight loss on their patients with obesity. Many PwO (62%) and physicians (73%) agreed that a complete change in lifestyle would be required for PwO to lose weight and felt that treatment of obesity should be a team effort between different healthcare professionals (HCPs; 80 and 90%, respectively). Dietitians were considered by 82% of physicians to be the most effective professionals in helping PwO achieve their weight loss goals. Many PwO (69%) liked that their HCP initiated weight management discussions and 68% of those who had not previously discussed their weight would like their HCP to initiate the conversation. However, among PwO who had discussed their weight with an HCP, 59% considered the discussions to be a little helpful or not at all helpful. The beliefs that patients have little interest in or motivation for losing weight were identified by physicians as the main reasons (71 and 70%, respectively) for not initiating weight management discussions. Conclusions In line with the ACTION-IO international study, our Israeli dataset reveals a need to improve awareness, primarily among physicians, on the physiologic basis and clinical management of obesity, including how to approach weight and weight management discussions during patient consultations. Trial registration Registered at ClinicalTrials.gov, NCT03584191. Data first posted on ClinicalTrials.gov: 12 July 2018 - ‘Retrospectively registered’.

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

Cited by 53 publications

References 43 publications

Perceptions, Attitudes, and Barriers to Obesity Care in Mexico: Data From the ACTION‐IO Study

Perceptions, Attitudes, and Barriers to Obesity Care in Mexico: Data From the ACTION‐IO Study

Long-Term Changes in Weight in Patients With Severe and Complicated Obesity After Completion of a Milk-Based Meal Replacement Programme

ACTION-IO as a platform to understand differences in perceptions, attitudes, and behaviors of people with obesity and physicians across countries – the Israeli experience

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