Attitude and Acceptance of Obesity Healthcare in Germany: Results of a Representative Online Survey among Adults with Obesity.

INTRODUCTION: Despite clinical obesity guidelines recommending evidence-based treatment, people with obesity have limited access to these treatments due to restrictions in the healthcare system. At present, little is known how individuals with obesity experience healthcare and what are their opinions on current treatment options. METHODS: To collect data on the attitude and acceptance of current obesity treatment options, a representative online survey among adults with obesity (body mass index, BMI ≥30.0 kg/m2) living in Germany was performed in October 2024. Questions covered demographics, the subjective burden of obesity, discrimination, weight loss attempts and success, as well as use of specific weight reduction approaches. The data were weighted to represent the adult population in Germany. Data were analyzed descriptively and by using chi-squared tests and multiple logistic regression analysis. RESULTS: In total, 1,004 adults (51.2% women) with obesity participated, with a mean BMI of 35.2 ± 5.2 kg/m2 and a mean age of 50.0 ± 17.1 years. In total, 78.4% of all participants (787/1,004) answered to feel moderately to very much burdened by their body weight, and 37.4% of participants (361/966) reported to have already been disadvantaged or discriminated against because of their body weight. Logistic regression analyses showed statistically significant differences by gender, age-groups, BMI groups, and educational status (most p < 0.05). The majority of participants (89.7%, 865/964) reported to have had at least one weight loss attempt. Regarding evidence-based treatment options, most participants stated to have not yet used weight loss medication (95.3%, 953/1,000) and that it is unlikely that they would take them in the future (88.4%, 791/895). Moreover, most participants stated to have not yet used reimbursable digital behavioral programs (96.7%, 966/999) or surgery (97.3%, 969/996) for weight loss. CONCLUSION: The findings indicate a gap between obesity treatment guidelines and real-world weight loss practice among adults with obesity. This might be due to stigma and access barriers. Therefore, more and better communication is needed between healthcare providers and people with obesity.