- Patients with obesity lack the health literacy and diagnoses necessary to motivate them to access long-term care solutions, according to new research published in Obesity. These findings suggest that clinicians need to leverage better patient-provider communication surrounding a patient’s health status.
Researchers conducting the Awareness, Care, Treatment in Obesity Management (ACTION) Study stated that very few of the more than 90 million patients with obesity actually seek long-term care for their medical condition.
This care gap may be due to inadequate patient-provider communications. Seventy percent of patients have spoken with their healthcare providers about their weight. Of those patients, only 55 percent have received a formal diagnosis for obesity, and only 24 percent have been referred to weight loss follow-up care.
Many patients are not fully aware of their weight-related health risks, the researchers found. Although more than two-thirds of patients acknowledged that obesity is serious or more serious than other chronic health conditions, few patients recognized the seriousness of their own personal prognoses.
All study participants reporting obesity met the height and weight requirements for the condition, the researchers said. However, only 50 percent of those patients self-reported as “obese” or “extremely obese,” highlighting a lack of patient education and patient-provider communication about the condition.
Provider efforts could be falling short, the research showed. Fifty percent of provider respondents agreed that obesity is as serious as other chronic diseases, but providers did not always discuss obesity with patients. Fifty-two percent of providers said they had insufficient time to discuss weight issues with patients, and 45 percent said there were more pressing health issues to discuss during the care encounter.
For their part, 62 percent of providers said they initiate most of the weight loss conversations they have with patients. Sixty-seven percent of providers are at least comfortable discussing weight with patients.
Sixty-nine percent of providers said they “always” or “most of the time” record an overweight or obese note in a patient’s EHR. Just under half (43 percent) of providers who said they do not usually make a note reported that they make a verbal diagnosis.
Inadequate patient-provider communication about obesity could be leading patients to take on most weight loss responsibility themselves, a factor which may discourage patients from seeking medical care for their obesity.
Most of the patients included in the study are currently engaging in or have previously engaged in weight loss activities. Eighteen percent of patient respondents described themselves as “committed to a weight loss plan” during the study.
However, few are able to lose the weight or keep it off for a prolonged period. Only one-quarter of patients have seen any sort of successful weight loss within the past three years. Fewer than half (44 percent) have kept the weight off for more than a year.
These findings point to needed improvements in obesity care coaching and patient-provider communication, said study co-author and ACTION steering committee member Angela Golden, MD.
"The barriers identified in the study highlight opportunities to bridge gaps in understanding to facilitate true collaboration among all stakeholders," Golden, who also owns a specialty obesity practice in Arizona, noted in a statement. "Only by bridging these gaps will obesity care become integral to standard practice, whether in a health care or employment setting, and will people with obesity have the care and support needed to effectively treat their obesity."
Lead author Lee Kaplan, MD, shared similar sentiments, adding that healthcare professionals need to treat obesity with more seriousness.
"We in the health care community must ask why this epidemic is not being diagnosed and treated with the same urgency and focus as any other serious diseases?" said Kaplan, who is also director of the Obesity, Metabolism and Nutrition Institute at Massachusetts General Hospital.
"We need to fundamentally rethink obesity so that the public and health care community understand more about the biology, chronicity and overall health impact of this disease,” Kaplan concluded. “Real progress can be achieved if we can overcome the entrenched mindsets that generate the barriers revealed by this study."