RT Journal Article SR Electronic T1 Changing the narrative around obesity in the UK: a survey of people with obesity and healthcare professionals from the ACTION-IO study JF BMJ Open JO BMJ Open FD British Medical Journal Publishing Group SP e045616 DO 10.1136/bmjopen-2020-045616 VO 11 IS 6 A1 Carly A Hughes A1 Amy L Ahern A1 Harsha Kasetty A1 Barbara M McGowan A1 Helen M Parretti A1 Ann Vincent A1 Jason C G Halford YR 2021 UL http://bmjopen.bmj.com/content/11/6/e045616.abstract AB Objectives To investigate the perceptions, attitudes, behaviours and potential barriers to effective obesity care in the UK using data collected from people with obesity (PwO) and healthcare professionals (HCPs) in the Awareness, Care, and Treatment In Obesity maNagement–International Observation (ACTION-IO) study.Design UK’s PwO (body mass index of ≥30 kg/m2 based on self-reported height and weight) and HCPs who manage patients with obesity completed an online survey.Results In the UK, 1500 PwO and 306 HCPs completed the survey. Among the 47% of PwO who discussed weight with an HCP in the past 5 years, it took a mean of 9 years from the start of their struggles with weight until a discussion occurred. HCPs reported that PwO initiated 35% of weight-related discussions; PwO reported that they initiated 47% of discussions. Most PwO (85%) assumed full responsibility for their own weight loss. The presence of obesity-related comorbidities was cited by 76% of HCPs as a top criterion for initiating weight management conversations. The perception of lack of interest (72%) and motivation (61%) in losing weight was reported as top reasons by HCPs for not discussing weight with a patient. Sixty-five per cent of PwO liked their HCP bringing up weight during appointments. PwO reported complex and varied emotions following a weight loss conversation with an HCP, including supported (36%), hopeful (31%), motivated (23%) and embarrassed (17%). Follow-up appointments were scheduled for 19% of PwO after a weight discussion despite 62% wanting follow-up.Conclusions The current narrative around obesity requires a paradigm shift in the UK to address the delay between PwO struggling with their weight and discussing weight with their HCP. Perceptions of lack of patient interest and motivation in weight management must be challenged along with the blame culture of individual responsibility that is prevalent throughout society. While PwO may welcome weight-related conversations with an HCP, they evoke complex feelings, demonstrating the need for sensitivity and respect in these conversations.Trial registration number NCT03584191.Data are available upon reasonable request. De-identified participant data will be made available for this article on a specialised SAS data platform. Datasets from Novo Nordisk will be available permanently after completion of data analysis. Access to data can be made through a request proposal form and the access criteria can be found online (novonordisk-trials.com). Data will be shared with bona fide researchers submitting a research proposal requesting access to data. Data use is subject to approval by the independent review board.