Inertia in Medical Care for Obesity in Europe

SisyphusThere’s both good news and bad news in a new study of physician attitudes about obesity in Europe. The good news is that, by and large, most physicians in this sample get it. Obesity is a disease they should be treating. The bad news? They’re not really doing it. Dig into the results and what you find is a familiar story – inertia in medical care for obesity in Europe.

These physicians prefer to simply prescribe diet and exercise for dealing with obesity. More effective treatments – anti-obesity meds or surgery – remain a “last resort.”

A Small Descriptive Study

This study appears in Obesity Science & Practice with Francesco Rubino as lead author. The authors completed an online survey with 197 physicians from eight European Countries: UK, Germany, France, Spain, Italy, Sweden, Switzerland, and Denmark. In this small sample, comparisons between countries were not possible.

But the results were remarkably consistent:

“The vast majority of respondents in this study signalled they see obesity as a disease that should be treated. However, most HCPs said to have recommended diet and exercise as weight loss strategies and indicated a belief that these options should be prioritized over evidence-based methods for weight loss, such as bariatric surgery or AOMs.”

Overestimating the Effectiveness of Diet and ExerciseOverestimating Diet and Exercise

In our own research, we have seen attitudes that fall in line with this – both in the U.S. and the U.K. In 2019, nearly 60 percent of adult respondents in the U.K. expressed a belief that self-directed diet and exercise is the most effective treatment for obesity. That was even more than we saw in the U.S., where 53 percent expressed a similar belief.

This flies in the face of overwhelming evidence for the effectiveness of bariatric surgery to produce lasting reductions in obesity, reverse complications such as diabetes, and add years to the lives of people with severe obesity.


Thus, in Europe as in the U.S., we find inertia in medical care for obesity. It is causing an ever larger burden of chronic diseases. Obesity is treatable with good medical care. Yet, doctors and patients conspire in hoping that somehow good intentions and good behavior will reverse this chronic and progressive condition. Health systems are happy to play along, denying coverage for this care.

Like Sisyphus pushing the rock up that hill, people imagine that somehow it will be different next time.

Sisyphus, painting by Titian / WikiArt

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May 17, 2021