America Speaks and the Survey Says… Obesity Viewed as Big a Health Threat as Cancer,
But Many Have Misperceptions About Treatment

Published in November Issue             

The risks of obesity appear to be better understood than ever, but Americans are seemingly at a loss when it comes to treating the disease that they consider as big a health threat as cancer and even bigger than heart disease, the nation’s leading cause of death, according and to a new national survey from the American Society for Metabolic and Bariatric Surgery (ASMBS) and NORC at the University of Chicago. The survey of 1,509 adults is representative of the U.S. population and was released during ObesityWeek 2016.

The ASMBS/NORC Obesity Poll finds that 81 percent of Americans consider obesity to be the most serious health problem facing the nation, tying cancer as the top issue, ahead of diabetes (72 percent), heart disease (72 percent), mental illness (65 percent), and HIV/AIDS (46 percent).

Nearly all Americans (94 percent) agree that obesity increases the risk of an early death, even when no other health problems are present. Yet, despite the seriousness with which they take obesity, the vast majority incorrectly perceive diet and exercise alone to be the most effective long-term weight loss method, and 1 in 3 of those struggling with obesity, say they have never spoken with a doctor or health professional about their weight. And, in another troubling note, only 12 percent of those with severe obesity, say a doctor has ever suggested they consider weight-loss surgery.

Most Americans consider diet and exercise on one’s own to be the most effective method (78 percent) for long-term weight loss, saying it’s even more effective than weight-loss surgery (60 percent) and prescription obesity drugs (25 percent).

“This survey reveals that Americans understand the risks of obesity, but hold major misperceptions about the causes of the disease, the effectiveness of the different treatments and the importance of involving the medical community in their care,” said Raul J. Rosenthal, MD, President, ASMBS and Chairman, Department of General Surgery, Cleveland Clinic Florida. “I think obesity may be the only life-threatening disease where more than a third of the patients do not consult a doctor for treatment, and where the vast majority do not explore more effective treatment options than the ones they repeatedly turn to that yield little
long-term success.”

The ASMBS/NORC Obesity Poll finds about 60 percent of Americans are currently trying to lose weight, although most everyone with obesity has tried before (94 percent). More than half of those with obesity have tried at least five previous times, and 1 in 5 have made more than 20 attempts to lose weight over their lifetimes. Only 22 percent of obese Americans rate their health positively, and half report being diagnosed with two or more
chronic conditions.

“Diet and exercise alone is simply not the most effective long-term treatment. It’s an important component, but on its own, it’s probably the least effective option for most people with obesity,” said
John M. Morton, MD, MPH, chief of bariatric and minimally invasive surgery at Stanford University School of Medicine and ASMBS immediate past president. “We have to get people, and even the medical community, to go beyond ‘eat less and exercise more.’ That’s too simple an answer for a complex disease like obesity. We have an expanding spectrum of treatments and many are underutilized because they are misperceived or poorly understood.”

When it comes to safety, 88 percent of Americans say losing weight through diet and exercise, especially with the help of a doctor, is the safest way to go, while prescription medications (15 percent) and dietary supplements (16 percent) are perceived to be the least safe. As for weight-loss surgery, Americans are divided, with about one-third of each who believe it to be safe (31 percent), unsafe (37 percent), or neither safe nor unsafe (31 percent). Despite the mixed feelings, a majority of Americans (68 percent) think that living with obesity is still riskier than having weight-loss surgery.

Weight-loss surgery has become extremely safe, comparable in safety to gallbladder and hip replacement surgery, two of the most commonly performed operations in America. Despite its safety profile, less than 1 percent of those who fit the criteria for weight-loss surgery actually go on to get the procedure. Less than 200,000 procedures are performed each year.

“We do see greater access to weight-loss surgery, but many patients appear to be in denial about their own obesity and health issues, which may prevent them from seeking surgery,” said Dr. Rosenthal.

The ASMBS/NORC Poll suggests this may be the case. Using
self-reported height and weight to calculate body mass index, the ASMBS/NORC Obesity Poll assessed a person’s perceptions of their own weight status, and 57 percent of obese respondents underestimated where they were. Almost half (47 percent) said they were overweight or about the right weight (10 percent). Men were more likely to underestimate their weight than women (66 percent vs 50 percent).

The survey also revealed the public thinks differently about obesity than the medical community. While health professionals have generally reached consensus that obesity is a disease (the AMA and other medical groups declared it so in 2013), little more than one-third (38 percent) of Americans agree, with most considering it simply a risk factor for other diseases. Additionally, health experts say obesity is caused by a combination of genetic, environmental, and social factors, yet nearly half of all Americans (48 percent) believe it is caused primarily by a person’s lifestyle choices and that the biggest barrier to weight loss is a lack of willpower (75 percent).

For many Americans, concerns about their weight dominate their life. About 1-in-3 worry about gaining weight all or a good deal of the time, but those with obesity are more than twice as likely to report being chronically worried (54 percent) than non-obese individuals
(20 percent). Of those who worry about their weight, the majority are extremely or very concerned about the health consequences. In fact, it appears nearly all Americans
(98 percent) know about the increased risk that obesity poses for developing diabetes and most know obesity increases the risk for developing certain types of cancer (82 percent).

The survey was funded by ASMBS and used AmeriSpeak, the probability-based panel of NORC at the University of Chicago and was conducted between August 11 and September 21, 2016. AmeriSpeak enabled the survey to be done online as well as with landlines and cell phones with high rates of participation. The margin of sampling error is +/- 3.5 percentage points.

Two reports associated with the survey: “Obesity Rises to Top Health Concern for Americans, but Misperceptions Persist,” and, “New Insights into Americans’ Perceptions and Misperceptions of Obesity Treatments, and the Struggles Many Face” are available at: http://www.norc.org/Research/Projects/Pages/the-asmbsnorc-obesity-poll.aspx