New US study reveals key reasons why millions of people with obesity are not receiving adequate care

Few of the more than 90 million Americans(1) with obesity are seeking and receiving long-term obesity care, according to new data from the Awareness, Care and Treatment In Obesity Management (ACTION) Study published in Obesity,(2) the official journal of The Obesity Society. Among the notable findings is that of the 71% of people with obesity who say they have spoken with a healthcare professional (HCP) about their weight in the past 5 years, only 55% report having been given a diagnosis of obesity and less than a quarter (24%) were offered follow-up care for this disease.(2) ACTION data will be presented through poster and symposia forums at ObesityWeek, currently in progress in Washington DC.

Designed to identify key barriers to care from the perspective of people with obesity, HCPs and employers, the results of the ACTION Study, according to multi-disciplinary steering committee members who led the initiative, can guide collaborative action to improve care, education and support for those who live with obesity.

"We in the healthcare community must ask why this epidemic is not being diagnosed and treated with the same urgency and focus as any other serious diseases?'" said Dr Lee Kaplan, director of the Obesity, Metabolism and Nutrition Institute at Massachusetts General Hospital, ACTION steering committee member and lead author of the study. "We need to fundamentally rethink obesity so that the public and healthcare community understand more about the biology, chronicity and overall health impact of this disease. Real progress can be achieved if we can overcome the entrenched mindsets that generate the barriers revealed by this study."

Conducted with more than 3,500 participants spanning all three target groups, the ACTION Study reveals five key barriers to comprehensive care:

people with obesity engage in several serious weight loss attempts but only a few are able to maintain the achieved weight loss;

despite recognition of obesity as a disease, most people with obesity consider weight loss to be completely their own responsibility, which may prevent them from seeking help from their HCP;

nearly half of people with obesity have not been given a formal diagnosis of obesity;

the patient-provider dialogue about weight management is insufficient with limited follow-up; and

employer wellness programmes are not meeting the needs of people with obesity.

"The barriers identified in the study highlight opportunities to bridge gaps in understanding to facilitate true collaboration among all stakeholders," said study co-author and ACTION steering committee member Dr Angela Golden, owner of a specialty obesity practice in Arizona. "Only by bridging these gaps will obesity care become integral to standard practice, whether in a healthcare or employment setting, and will people with obesity have the care and support needed to effectively treat their obesity."

About ACTION

The "Awareness, Care and Treatment In Obesity Management" (ACTION) Study is the first US nationwide study to investigate barriers to obesity management from the perspective of people with obesity, healthcare professionals and employers. In addition, the study aims to generate insights to guide collaborative action to improve obesity care, education and support. Sponsored by Novo Nordisk, the ACTION Study was led by a multi-disciplinary steering committee comprised of representatives from The Obesity Society, the Obesity Action Coalition, and the Integrated Benefits Institute as well as obesity experts in the fields of primary care, endocrinology, psychology and nursing. The study involved more than 3,000 people with obesity, 600 healthcare professionals, and 150 employers in the United States. To learn more about the study, please visit www.ACTIONStudy.com.

About obesity

Obesity is a disease(3,4) that requires long-term management. It is associated with many serious health consequences and decreased life expectancy.(5,6) Obesity-related comorbidities include type 2 diabetes, heart disease, obstructive sleep apnoea (OSA) and certain types of cancer.(5,7,8) It is a complex and multi-factorial disease that is influenced by physiological, psychological, environmental, socio-economic and genetic factors.(9)

The global increase in the prevalence of obesity is a public health issue that has severe cost implications to healthcare systems. In 2014, 13% of adults, or approximately 600 million adults, were living with obesity.(10)

About Novo Nordisk

Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. This heritage has given us experience and capabilities that also enable us to help people defeat other serious chronic conditions: haemophilia, growth disorders and obesity. Headquartered in Denmark, Novo Nordisk employs approximately 41,400 people in 77 countries and markets its products in more than 165 countries.

1. Obesity and Overweight. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/nchs/fastats/obesity-overweight.htm. Last accessed: October 2017.
2. Kaplan L, Golden A, Jinnett K, et al. Perceptions of Barriers to Effective Obesity Care: Results from the National ACTION Study. Obesity. 2017;DOI:10.1002/oby.22054.
3. American Medical Association. A.M.A Adopts New Policies on Second Day of Voting at Annual Meeting. Obesity as a Disease. Available at: http://news.cision.com/american-medical-association/r/ama-adopts-new-policies-on-second-day-of-voting-at-annual-meeting,c9430649. Last accessed: October 2017.
4. WHO. Obesity: Preventing and managing the global epidemic. Available at: http://www.who.int/iris/handle/10665/42330 Last accessed: October 2017.
5. Guh DP, Zhang W, Bansback N, et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:1-20.
6. Peeters A, Barendregt JJ, Willekens F, et al. Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Annals of Internal Medicine. 2003;138:24-32.
7. Gami AS, Caples SM, Somers VK. Obesity and obstructive sleep apnea. Endocrinology and Metabolism Clinics of North America. 2003;32:869-894.
8. Whitlock G, Lewington S, Sherliker P, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373:1083-1096.
9. Wright SM, Aronne LJ. Causes of obesity. Abdominal Imaging. 2012;37:730-732.
10. World Health Organization. Obesity and Overweight Factsheet no. 311. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/. Last accessed: October 2017.