Clinicians' and Consumers' Perspectives of Obesity Treatments

Abstract

Background: Obesity is associated with an increased risk of many non-communicable diseases, including cardiovascular disease, diabetes and cancer. Currently in New Zealand almost one third of all adults are classified as obese or having a Body Mass Index (BMI) of over 30kg/m2. Rates of obesity in New Zealand and around the world continue to rise, despite attempts from many suffering from obesity to lose weight. Traditionally, methods used by those trying to lose weight have involved increasing physical activity (energy expenditure), and decreasing the amount of calories consumed in the form of food and beverages (energy intake). It is now recognised that owing to various biochemical and genetic differences between individuals, some may find it easier to lose weight than others. Nevertheless, health professionals and sufferers alike are awakening to the multi-faceted nature of this disease and therefore the need for a multi-faceted treatment approach. In the present study, consumers and clinicians shared their thoughts about the barriers to and enablers of the effectiveness of current obesity treatments, and their suggestions for the future.

Objective: The overall aim of the present study was to investigate the similarities and differences between clinicians’ and consumers’ perspectives of obesity treatments, in order to contribute to the existing body of literature and to develop hypotheses for future research. Design: An observational design for data collection, and a thematic analysis technique to analyse data were used in the present qualitative study. A total 61 participants were recruited including 32 ‘clinicians’ and 29 ‘consumers’. Eight focus groups were conducted, recorded and transcribed verbatim before analysis. All data were analysed using thematic analysis, a ‘bottom-up’ approach to identifying key themes. NVivo qualitative software was used to organise the data and to assist with the generation of codes throughout the analysis.

Results: The participants in this study agreed that obesity treatments could be improved by increased psychological intervention, including efforts to reduce the impacts of obesity stigma; tailored educational materials and treatment campaigns to meet the needs of ethnic minorities; and initiatives that promote enjoyment, strength of community, and long-lasting follow-up and support. Barriers to the achievement of obesity treatment success included the influence of distorted nutritional messages within food marketing and media advertising on consumers’ perceptions of healthy food; and the overall lack of reliable treatment initiatives for those seeking behaviour change and thus weight management.

Conclusion: Consumers and clinicians alike are exasperated and discouraged by the lack of effectiveness of obesity treatments. Feelings of frustration, anger, hopelessness and desperation resonated from both sides of the patient/provider fence throughout this explorative study. However, despite this apparent negativity, consumers especially illustrated a persistent defiance to overcome their battles with weight. Overall, clinicians appeared to lack a defined treatment pathway for the treatment of obesity. This warrants further investigation before a multi-disciplinary approach to treatment can be achieved.