Management and impact of obesity in Canada: A real-world survey of people with obesity and their physicians
Bibliographic record
Abstract
Obesity is a chronic relapsing disease associated with multiple complications. This study described real-world demographic/clinical characteristics, including obesity-related complications (ORCs), prescribing rationale, and patient-reported outcome measures (PROMs) for adults living with obesity in Canada accessing treatment. This was a cross-sectional survey of physicians and consulting people with obesity (PwO) in Canada with retrospective data capture in a real-world setting. Canadian data were drawn between July and November 2022 from the multinational Adelphi Real World Obesity Disease Specific Programme™. Consulting PwO were required to be on a weight management program and/or have a current body mass index of ≥30 kg/m 2 . Physicians completed questionnaires for the next 3–5 consecutive PwO seen in their routine clinical practice. A quota was applied for obesity management medication (OMM). PROMs including Work Productivity and Activity Impairment (WPAI) questionnaire were provided voluntarily by PwO. Analyses were descriptive. Overall, 50 physicians (35 general practitioners, 15 endocrinologists) and 199 PwO were analyzed. More than 85 % of PwO had ≥1 ORC. The most common ORCs were hypertension, dyslipidemia, depression, and type 2 diabetes, and one-quarter to one-half of ORCs were not optimally controlled. Approximately two-thirds of the cohort were employed full-time, almost half had private insurance, and almost 70 % were classified as high socio-economic status. Mean number of weight-reduction attempts over the past 3 years was 2.9. Pharmacological treatment for obesity was common among those with ORCs. A general trend towards greater work impairment among people with ORCs than for PwO without ORCs was observed. Among PwO participating in our study, ORCs were common, often uncontrolled, and their presence impacted the likelihood of obesity treatment and possibly impaired work productivity. Medical treatment for obesity was often delayed until ORCs developed, suggesting that preventative healthcare measures are not the norm for PwO in Canada. A large proportion of PwO had high socioeconomic status, suggesting that PwO who access treatment may not be representative of the overall population of PwO in Canada. • Obesity is a chronic, relapsing and burdensome disease that is often not treated appropriately in Canada due to socioeconomic, healthcare system and payer barriers. • >85 % of people with obesity (PwO) in the study had obesity-related complications (ORCs), and obesity management medication (OMM) was prescribed primarily for those with ORCs, suggesting that treatment is mostly initiated after ORCs occur rather than preventatively. • WPAI questionnaire results suggest that there was a general trend towards greater activity/work impairment among PwO who had ORCs than for those without ORCs, although statistical analysis was not conducted. • Effective treatment should be accessible for all PwO in Canada to help reduce obesity and ORCs, but further work is needed to achieve this goal, including educating physicians and improving equitable access to OMM, particularly for the prevention of ORCs.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".