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Literature Review on Patients’ Perception and Attitude in Obesity Management

                One of the recognized risk factors for chronic conditions is obesity. According to Sturgiss, Elmitt, Haelser, van Weel, and Douglas (2018), the condition is comorbid with other disorders including cardiovascular, depression, and diabetes. Managing obesity is, therefore, identified as a profound measure in preventing these conditions. The management strategies are categorized into three. These include pharmacological, nonpharmacological, and surgery. According to Kennedy, Kennedy, Sarpong, and Katzmarzyk (2016), the management approach is dependent on various factors including the patient’s BMI, other health conditions, and response to medication. According to the Center for Disease Control and Prevention (CDC), non-pharmacological management approaches, which mainly involve behavioural change, are the most effective since they also enhance the individual’s overall health. An apparent factor, however, that plays a role in the effectiveness of the management is the individual’s involvement in implementing the management plan.

This literature review, therefore, is centred on how the attitude and perception of obese patients on treatment approach influences their selection and implementation of the management plan. Included in the literature review is the theoretical framework and analysis of different sources related to the topic. Notably, the sources selected were published within the last six years. The literature review is based on the PICOT question: For obese patients between 40-50 years (P), how does their perception and attitude towards lifestyle modification (I) compare to medication (C) in selecting and implementing the management plan for significant outcomes such as weight loss and enhanced quality of life (O) over three months (T)?

Theoretical Framework

                The conceptual framework for this literature review is informed by two main terms; perception and attitude. According to Seah, Tham, Kamaruzaman, and Yobas (2018), the theory of planned behaviour (TPB) is profound in examining the reasons behind an individual’s actions. These authors further espouse that the TPB is used in predicting one’s behaviours that the person is able to decide whether to exhibit or not. There are three variables in this theory which include attitudes, perceived behavioural control, and subjective norms. Notably, these variables have significant influence on one’s intention. Han (2015) note that behavioural intention can also be influenced by beliefs, experience, and social interactions. The importance of this theory in the literature review is relating to the selection of a treatment or management plan for obesity and its implementation. In line with the research aims and objectives, TPB theory will also be used in examining the most preferred management approach and establish whether nurses have a role in the individual’s adoption of a particular treatment approach.

Obesity Management Strategies

                The United States Preventative Services Task Force (USPSTF), through its recommendation statement of 2018, noted that weight loss is the foundation of managing obesity. As noted by Yanovski (2018), weight loss interventions adequately address the mortality and morbidity associated with obesity and especially for patients with a BMI of above 30. Lanoye, Gorin, and LaRose (2016), in an examination of perceptions and attitudes of managing obesity, support the weight loss factor and adds that behavioural management is critical in weight management. The demographic factors, according to these authors, demonstrate that young adults between 18-35 years are the most affected by the condition based on their engagement in poor behaviours such as unhealthy eating and lack of exercises. Considering the pharmacological management of the condition, it is recommended for use in particular situations where the physician will prescribe weight loss medication (Granara, 2017). However, the effectiveness of these medications cannot be realized if the patient does adopt behavioural management strategies.

Drawing from this section on obesity management, it is apparent that there are different approaches which further include gastric bypass surgery in adverse obesity condition. This introduces the holistic management strategies which combine the pharmacological and behavioural management strategies. Lanoye et al. (2016) argue that the individual’s attitude plays a central role in implementing the management approach. The assertion that behavioural management is the most effective is centred on the healthcare providers’ selection and knowledge, but not that of patients. This research will, therefore, establish the perception and attitude of patients towards the medication and lifestyle modification management strategies.

Perception and Attitude in Influencing Obesity Management

                Although obesity prevalence and awareness remain high globally, consistent and appropriate management approaches are variable. This is asserted by Granara (2017) who notes that for individuals screened and noted to have a BMI of above 30 kg/m³, they should be referred to multicomponent and intensive behavioural interventions. What these authors imply is that the management of obesity is not successful among all populations as a result of different factors including one’s perception and commitment to implementing the interventions. This is asserted by Bucher Della Torre, Courvoisier, Saldarriaga, Martin, and Farpour-Lambert (2018), who note that the inefficiency in obesity management is based on the lack of skills and competence among the healthcare providers as well as patient’s perception and attitude of the treatment approach. In behavioural management, the influence of attitude and perception is centred on the bias and stigma that these patients face from the society which negatively impacts their motivation to adopt the recommended management approaches (Fruh, Nadglowski, Hall, Davis, Crook, & Zlomke, 2016).

Despite the presentation of various factors hindering the comprehensive management of obesity among adults, it is not established which strategy is the most effective between lifestyle modification and medication according to the patients and how the perception and attitude of the patient influence the adoption of the treatment approach. In addition, it is not established whether nurses have influence on the patient’s selection and implementation of the management approach which is part of the objectives of this study.

In summary, obesity remains a critical condition among adults. Despite the development of various management strategies, the elimination of the condition is not effective, and several factors play a role such as skills and competence of the healthcare providers and the perception of the patients. Drawing from literature, it is apparent that the attitude and perception of the patients towards medication and lifestyle modification remains under evaluated as well as the role of nurses in influencing the selection of the treatment which is among the objectives of this research.