Time To Take ACTION! Barriers To Effective Obesity Care

Despite the fact that obesity is one of the most prominent medical conditions in existence, it is sadly one of the most poorly treated. There exists very little education about obesity for health care providers, and the stigma against obesity is even stronger in the medical community than it is in the general population. Although this is slowly changing, only a small minority of people with obesity actually have this medical condition addressed and treated with the help of their health care provider.

The ACTION study was thus designed to better understand the barriers to effective obesity care. This study was a survey conducted in USA, completed by three groups of people:

• 3,008 people with obesity
• 606 health care providers (primary care/family medicine, internal medicine, and obesity specialists)
• 153 employers who provide health insurance or wellness programs to their employees

Here are some of the key findings: 

1.  While over 80% of health care providers viewed obesity as a chronic disease, only 55% of people with obesity reported receiving an actual diagnosis of obesity. (How can a health care provider move towards treatment of this medical condition if they are not making the diagnosis?)

2. Top 5 reasons that health care providers reported as to why they may not initiate a conversation about weight loss: 

• not enough time
• more important issues to discuss
• they did not believe their patient was motivated to lose weight 
• they did not believe their patient was interested in losing weight (au contraire - data supports that the vast majority of people with obesity are interested in losing weight)
• concern over patient's emotional state or psychological issues

3.  Top 5 barriers to initiating a weight loss effort (agreed to be the same top 5 by people with obesity, health care providers, and employers):

• lack of exercise (note: exercise is less important for weight loss and more important for weight maintenance)
• lack of motivation (could this be because of a lack of understanding of the causes and contributors to each individual's weight struggle?)
• preference for unhealthy food (could this be because food is being used to medicate untreated depression or pain by releasing 'happy hormones' in our brains?)
• controlling hunger
• cost of healthy food

4. Only 24% of people who had a discussion about obesity with their doctor had a follow up appointment scheduled. (Obesity requires long term management - one appointment isn't enough!)

5. Only 17% of people with obesity felt that their employers' wellness offerings were helpful in weight management.


The ACTION study is truly a treasure trove of information that should help all components of  society better identify, understand, and gradually overcome the barriers to successful weight management.

You may be wondering if the results of the ACTION study applies to Canada or other countries, as attitudes and approaches can be very different in different parts of the world.  I'm thrilled to share that the ACTION study is currently underway in Canada (I am on the steering committee for this study) - stay tuned for our results next year. ACTION will be conducted in several countries around the world as well, with deployment planned to begin in 2018.

Disclaimer: The ACTION study is funded by Novo Nordisk, the maker of weight management medication Saxenda (liraglutide 3.0mg).

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