Breaking the weight of therapeutic inertia: obesity management in cardiology practice.

INTRODUCTION

Obesity is a major risk factor for cardiovascular diseases. While cardiologists play a key role in managing these patients, the extent of their involvement in obesity-related diagnosis and treatment remains unclear. This study aimed to assess the practices and approaches of cardiologists in Argentina regarding obesity management.

MATERIALS AND

METHODS

We conducted a cross-sectional survey using a web-based questionnaire. The survey was distributed via WhatsApp employing convenience and snowball sampling among cardiologists practicing in Argentina.

RESULTS

Of the 380 questionnaires sent, we received 363 responses. A total of 130 cardiologists (35.8%) were unaware of the normal body mass index (BMI) range. Most respondents did not routinely assess weight (n = 293; 80.7%) or waist circumference (n = 330; 90.9%), and only 101 (27.8%) consistently calculated BMI. Regarding lifestyle interventions, 218 cardiologists (60.1%) always recommended a healthy diet, and 306 (84.3%) always promoted physical activity. Pharmacological treatment had never been prescribed by 207 respondents (57.0%), and 237 (65.3%) had never recommended metabolic surgery. Glucagon-like peptide-1 receptor agonists were the most frequently administered treatment, reported by 123 cardiologists (78.9% of those who prescribed pharmacological treatment). In multivariate analysis, >10 years of experience was significantly associated with prescribing pharmacological treatment (OR: 2.51; 95% CI: 1.52-4.17) and referring patients for metabolic surgery (OR: 2.37; 95% CI: 1.41-3.96). Practicing in the private sector was associated with the prescription of pharmacological treatment (OR: 2.97; 95% CI: 1.04-8.49), whereas male cardiologists demonstrated a greater propensity for referring patients for metabolic surgery (OR: 1.72; 95% CI: 1.02-2.92).

DISCUSSION: This study highlights the need for improvements in cardiologists' training and promotion of proactive behaviors in obesity management, as significant gaps in knowledge, diagnosis, and therapeutic interventions were identified.