Attitude and Belief of Healthcare Professionals Towards Effective Obesity Care and Perception of Barriers; An Updated Systematic Review and Meta-analysis

BACKGROUND

Obesity is a serious chronic disease that adversely affects health and quality of life. However, a significant percentage of people do not participate in or adhere to weight loss programs. Therefore, a multidisciplinary approach is needed to identify critical barriers to effective obesity management and to examine health practitioners' attitudes and behaviors towards effective obesity treatment.

METHODS

This systematic review was conducted in accordance with PRISMA 2020. Eligible studies were identified through a systematic review of the literature using Medline, Scopus, Cochrane, Google Scholar, Web of Science, and Embase databases from January 1, 2011 to March 2, 2021.

RESULTS

A total of 57 articles were included. Data on 12663 physicians were extracted from a total of 35 quantitative articles. Some of the most commonly perceived attitude issues included "obesity has a huge impact on overall health", "obesity is a disease" and "HCPs are to blame". Health professionals were more inclined to believe in "using BMI to assess obesity," "advice to increase physical activity," and "diet/calorie reduction advice." The major obstacles to optimal treatment of obesity were "lack of motivation", "lack of time" and "lack of success".

CONCLUSION

Although the majority of health care professionals consider obesity as a serious disease which has a large impact on overall health, counseling for lifestyle modification, pharmacologic or surgical intervention occur in almost half of the visits. Increasing the length of physician visits as well as tailoring appropriate training programs could improve health care for obesity.

A Pilot Randomized Trial Comparing a Commercial Weight Loss Program with a Clinic-Based Intervention for Weight Loss

Objective: To compare the efficacy of a popular commercial program with that of a clinic-based intervention for weight loss. Methods: Randomized clinical trial conducted at an internal medicine clinic affiliated with a city hospital in Denver, Colorado. Participant (n = 46) had a body mass index ≥ 30 kg/m2 and no life-threatening medical conditions. They either were provided a voucher to attend Weight Watchers for 17 weeks (n = 23), or they were assigned to the clinic group (n = 23), which provided 12 visits over 17 weeks and the option to augment weight loss using either meal replacements or weight loss medication. The primary study outcome was weight change. Results: Participants assigned to the clinic arm lost 4.0 ± 1.2 kg, compared to 0.4 ± 1.1 for those assigned to the commercial program ( P = .04 for difference). Weight losses in the clinic arm were 3.2 kg for meal replacements (n = 10) and 5.0 kg for phentermine (n = 13). Conclusions: In this single-site trial, a clinic-based intervention was more effective than a popular commercial program for weight loss. Primary care providers in the United States are under increasing pressure to combat the epidemic of obesity. This trial, although small, begins to address how the primary care setting might play that role.