Pharmacotherapy Use in Obesity Care: Divergence among Health Care Providers and Persons with Obesity

Background: Despite substantial recent improvements in the efficacy and safety profile of anti-obesity medications (AOMs), their utilization remains low. This study sought to understand better the basis for receptivity and resistance to AOMs among persons with obesity (PwO) and health care providers (HCPs). Methods: Telephone interviews were conducted in the US with 23 PwO (BMI >30 kg/m2 or 27 < BMI < 30 with a weight-related comorbidity) and 25 HCPs across 9 specialties, many of whose patients would benefit from effective obesity care. The interviews focused on attitudes towards weight management and perceptions of AOMs. Transcripts were analyzed to identify emerging themes. Results: HCPs generally reported viewing obesity as a chronic disease while PwO were more likely to see it as a self-modifiable condition. HCPs reported prioritizing obesity less than other conditions which they perceive as easier to treat; most were unaware of current obesity treatment guidelines. Most PwO did not see themselves as having obesity and were upset to see this diagnosis documented in their medical charts. Both HCPs and PwO viewed AOMs as a useful kick-start for weight loss but not as a long-term solution, feeling that lifestyle changes were essential to sustain weight loss. PwO perceived that HCPs may favor lifestyle measures over use of AOMs. In contrast to HCP perceptions, PwO are open to AOM therapy coupled with progress monitoring as part of a comprehensive treatment plan. Conclusions: Both HCPs and PwO view AOMs primarily as a shortterm treatment, despite HCPs viewing obesity as a chronic disease. PwO perceive the diagnosis of obesity negatively yet appear to be interested in comprehensive obesity treatment that could include AOMs. HCPs did not feel well-prepared to provide such care. Addressing the different perceptions about obesity in PwO and HCPs could enhance clinical communication and promote greater willingness to use AOMs as part of obesity treatment.