Physician perspectives in treating obesity: an insight from Pakistan
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Abstract
Objective: To explore physician barriers in obesity management and compare the perceptions and approaches of gastroenterologists and other medical specialists toward its pathogenesis and treatment, with a specific focus on behavioral and biological factors.
Methods: This cross-sectional survey was conducted at gastroenterology and hepatology conferences in Karachi (September 2023) and Islamabad (December 2023), Pakistan. The study design was adapted from a prior U.S.-based survey. A structured questionnaire assessed physician perceptions of five biological and two behavioral factors contributing to obesity, satisfaction in obesity management, and the perceived effectiveness of behavioral, pharmacologic, and surgical treatment modalities.
Results: Among 114 participants, 39 (34%) were gastroenterologists, and 75 (66%) were from other medical specialties. Perceptions of biological (6.40 [5.6–7.6], p=0.722) and behavioral (7.5 [6.5–8.5], p=0.564) factors were comparable across groups. Beliefs in behavioral factors correlated more strongly with perceived treatment efficacy, particularly for lifestyle modification (r=0.48, p <0.001) and medications (r=0.30, p=0.001), while weight-loss surgery had a weaker association. Lifestyle modification was consistently rated as the most effective treatment across both groups. Medications and bariatric surgery were perceived as significantly less effective than lifestyle modification or surgery alone (p<0.001 for both comparisons). There were no significant differences in biological or behavioral factor ratings between the groups.
Conclusion: This study highlights physicians' shared perspectives on obesity management, emphasizing the central role of lifestyle modifications. It identifies gaps in education and interventions needed to enhance satisfaction and treatment outcomes, emphasizing the importance of improved training and interdisciplinary collaboration for optimizing obesity care.
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