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. 2023 Oct 29;10(1):e720.
doi: 10.1002/osp4.720. eCollection 2024 Feb.

Patient perspectives about treatment preferences for obesity with complications

Hilary C Craig  1 , Dalal Alsaeed  2 , Suzanne Norris  3 , John Holian  4 , Cormac Kennedy  5 , Alix Feldman  6 , Carel Le Roux  1
Affiliations

Patient perspectives about treatment preferences for obesity with complications

Hilary C Craig et al. Obes Sci Pract. .

Abstract

Objective: Obesity and many of its comorbidities can be improved by nutritional therapy, lifestyle modification, pharmacotherapy, and surgical intervention. Relatively little is known about patients' preferences for the range of obesity treatments. The present study was undertaken to identify factors that may influence these preferences. By evaluating patient-preferred treatment options and factors influencing patients, treatment adherence and efficacy may be improved. Our objective was to identify factors that influence patient preferences and subsequent choice of obesity treatment among those seeking treatment for obesity-related complications.

Methods: Participatory action research, using purposeful sampling, was used to recruit 33 patients with obesity complications. Recruitment took place in specialist clinics for non-alcoholic fatty liver disease, diabetes, hypertension, and chronic kidney disease. Sixteen males and 17 females aged 18-70 years with a BMI>35 kg/m2 were recruited. Prior to the interview, participants watched a 60-min video explaining nutritional therapies, pharmacotherapies, and surgical therapies in equipoise. Data were collected in one-to-one semi-structured interviews using zoom or the telephone; reflective thematic analysis was used.

Results: Four themes emerged: 1) structural factors, 2) autonomy, 3) interaction with formal care, and 4) the emotional and physical consequences of obesity. 39% of participants preferred nutritional therapy with support from medical professionals. 27% chose bariatric surgery. 24% chose pharmacotherapy alone, while 6% chose pharmacotherapy combined with nutritional therapy, 3% of participants wanted no intervention.

Conclusion: The challenges can be addressed by increasing support for healthcare professionals toward enhancing both their knowledge and the health literacy of patients. Future research should focus on improving access to treatment pathways for patients as well as developing health literacy programs and educational programs for healthcare professionals.

Keywords: chronic disease management; integrated care; lifestyle therapies; obesity; pharmacotherapies; self‐care; stigma.

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Conflict of interest statement

Hilary C. Craig, Part funding of PhD tuition fees from the Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy (SOPHIA) project (www.imisophia.eu). Dalal Alsaeed—no conflict of interest. Suzanne Norris—no conflict of interest. John Holian—no conflict of interest. Cormac Kennedy—no conflict of interest. Alix Feldman—employed by Novo Nordisk. Carel W. le Roux: Consulting fees/Honoria/Support for meetings: NovoNordisk, Eli Lilly, Johnson & Johnson, Boehringer Ingelheim, GI Dynamics, Herbalife. Leadership/fiduciary role in Board: Irish Society for Nutrition and Metabolism (unpaid). Stock Options: Keyron Previous Chief medical officer and Director of the Medical Device Division of Keyron in 2011. Both of these were unremunerated positions. Previous investor in Keyron, which develops endoscopically implantable medical devices intended to mimic the surgical procedures of sleeve gastrectomy and gastric bypass. He continues to provide scientific advice to Keyron for no remuneration.

Figures

FIGURE 1
FIGURE 1
Participants' obesity treatment preferences.
See this image and copyright information in PMC

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