Obesity – the hidden truths we should care about

Jessica Brueggeman

MicroMass Communications, Inc.

Numbers don’t lie. Obesity isn’t just a Western phenomenon, it has quickly become a global concern. Many refer to it as a pandemic. A recent series of articles in The Lancet offers the staggering proof of this, the authors showing that the rates of obesity throughout the world have doubled since 1980.

And the impact isn’t just on our waistbands.

• The number of people with diabetes has more than doubled, increasing from 153 million in 1980 to an estimated 347 million in 2008

• Uncontrolled hypertension increased from 605 million in 1980 to nearly 1 billion in 2008

• Cholesterol levels are up in East and Southeast Asia and the Pacific region

Obesity also hits our wallets.

The U.S. leads the way, currently spending approximately $160 billion on obesity-related medical costs. In 2007, the UK spent $4 billion on obesity-related medical costs. Projections indicate that costs in both nations will double in the coming decades.

Why you should care about obesity even if you’re not marketing a weight loss product

Within the pharmaceutical landscape, most of us are not addressing obesity directly. It’s more likely that we are supporting products that are downstream from obesity – high cholesterol, hypertension, diabetes. But even if you are not directly targeting weight loss as an outcome, the patient and physician challenges specific to obesity can still affect your product’s success.

"...the rates of obesity throughout the world have doubled since 1980."

Here’s the challenge: most physicians want to be collaborative with their patients and want their patients to succeed, but lack the confidence that their patients can succeed in achieving positive clinical outcomes in lifestyle-driven conditions.

What physicians want from their patients

We recently conducted a primary research study with U.S.-based primary care and specialty physicians. Leveraging learnings from decades of behavioral science research, we examined numerous attitudinal and behavioral factors that drive treatment approaches in chronic diseases.

One specific area of the research examined physician preferences for patient involvement in the treatment and care process. We used a validated scale consisting of 13 items called the Clinician Scored Patient Activation Measure (CS-PAM®). In our study, the aggregate score of physicians using this validated measure was 71 (scale 0-100), signaling high preference for patient involvement in care.

For comparison, a study by Hibbard (2009), using the same validated scale with U.S. and UK physicians, reported an aggregate score of 69. Both sets of findings support the fact that physicians believe patient involvement in the care process is vital.

However, when you dig deeper and look at the results of the specific items within the scale, some interesting insights emerge. Physicians want patient collaboration, but they place greater value on patient involvement in specific areas.

Example: Our study demonstrated that physicians who treat diabetes believe it is more important for patients to understand the lifestyle and behavior changes needed to manage their condition than to understand specific treatment options or how their prescribed medication works.

Figure 1: As a clinician, how important is it to you that your patients with long-term conditions...

The confidence gap can affect product and patient success

So, physicians want a collaborative care model and they know that patient ownership in their disease management is critical, especially regarding lifestyle and behavior. But what's actually happening?

Our research showed that while physicians do place value on patient self-management, they’re not convinced that patients can do it on their own. And that skepticism ultimately affects physicians’ beliefs in their abilities to achieve positive clinical outcomes with their patients. In fact, more than half of the HCPs in our study believe that achieving an optimal outcome is difficult.

"...while physicians do place value on patient self-management, they’re not convinced that patients can do it on their own."

The patient picture reveals a similar confidence gap. A study we conducted with 828 patients showed that they are significantly more confident in taking medication vs. managing the lifestyle aspects of their diseases.

Figure 2: The Confidence Gap

Why aren’t they confident?

The fact is that most physicians are not having effective lifestyle and weight loss conversations with their patients. They aren’t equipped to do so from a time or skills standpoint. Some studies show that nearly half of physicians don’t feel they have the ability to adequately counsel patients about obesity. So the conversation doesn’t happen at all, or it happens in a less than ideal fashion.

What do we do about the confidence gap? And why should we care?

Bridging this confidence gap is the path to setting up patients and physicians for success with your product.

To bridge the gap, we first need to set aside stereotypes (obese people are lazy, undisciplined, etc.) and uncover the realtruths that lead to behavior change. We have to help physicians overcome their preconceived notions as well.

Sound difficult? Not necessarily. Overall, the greatest impact we can make as marketers is to better equip physicians to support patients in making lifestyle changes.

"...nearly half of physicians don’t feel they have the ability to adequately counsel patients about obesity..."

One approach is to invest in partnerships with third party associations or programs to enhance patient outcomes. A good example of this is Merck partnering with Weight Watchers on a U.S.-based effort in 2011. This pilot study will investigate the impact of arming physicians with a complementary behavioral-based solution to enhance their patients’ health.

Another way to instill confidence is by incorporating behavioral science strategies into your marketing efforts. An example is motivational interviewing. Create in-office tools and / or train physicians in this technique which is proven to improve efficiency of office visits and drive successful behavioral outcomes.

Take a hard look at your marketing plans. Are you going below the surface to see what’s keeping your customers from achieving success? Statistics don’t lie. The metabolic diseases marketplace has tremendous room for impact. We’ve got to think broader and more nontraditionally about how we drive success and value with our customers.

And who knows – maybe our waistlines and checkbooks will benefit as well.

About the author:

Jessica Brueggeman, RN, MPH, is director of behavioral services at MicroMass Communications, a specialist in the use of behavioral science to meet marketing challenges. She blends clinical knowledge and behavioral models to develop strategies that change both patients’ and health care providers’ behavior. Jessica joined MicroMass in 2000 and currently leads the behavioral services team. She has experience in nursing and health behaviors, with emphases in metabolic diseases, COPD, asthma, neurohealth, overactive bladder, and cervical cancer prevention. Jessica has a Master of Public Health from the University of North Carolina at Greensboro and a Bachelor of Science in nursing from the University of North Carolina at Chapel Hill.

She can be contacted by e-mail at jessica.brueggeman@micromass.com, or by telephone at 919-256-2403.

Are you going below the surface to see what’s keeping your customers from achieving success?