Divergence of patient and clinician perceptions of obesity and weight management

The ACTION (Awareness, Care & Treatment In Obesity MaNagement) study was designed to identify barriers reported by people with obesity (PWO) and clinicians that may hinder the initiation of treatment.

Focus groups including 43 PWO (class I: N = 14; class II: N = 13; class III: N = 16) and interviews with 24 clinicians (12 primary care providers and 12 obesity specialists) were conducted, transcribed, and coded thematically.

Most (75%) of PWO perceived themselves as 'healthy', although nearly three-quarters had obesity-related comorbidities. While PWO and clinicians considered obesity a combination of disease and lifestyle, their primary emphases differed; 65% of PWO considered obesity primarily a lifestyle issue, and 88% of clinicians considered it a disease. Motivation was perceived as a key barrier to weight loss by PWO and clinicians (77% vs. 75%, respectively); limited patient understanding of their condition less so (35% vs. 42%). Relative to clinicians, PWO more often cited barriers of food habits (88% vs. 38%), social relationships (79% vs. 38%) and feeling deprived while dieting (56% vs. 8%), and less often cited limited patient understanding of how to lose weight (9% vs. 58%). Importantly, PWO indicated that developing health complications or receiving a health-related 'wake-up call' would motivate them to address their obesity.

Perceptions of obesity vary between PWO and clinicians. This may be a barrier to effective communication/treatment, and contribute to suboptimal patient-clinician interactions. This qualitative association provides the basis for quantitative examination of these perceptions and their causes, the understanding of which could enhance patient-clinician collaboration in obesity treatment.