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

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Title:	Breaking the weight of therapeutic inertia: obesity management in cardiology practice.
Alternate Title:	Rompiendo el peso de la inercia terapéutica: abordaje de la obesidad en la práctica cardiológica.
Authors:	Garagoli, Fernando¹ (AUTHOR) fernando.garagoli@hospitalitaliano.org.ar, Bluro, Ignacio¹ (AUTHOR), Fiorini, Norberto¹ (AUTHOR), Slipczuk, Leandro² (AUTHOR), Barolo, Ramiro¹ (AUTHOR), Izaguirre, Andrés¹ (AUTHOR), Fernández Recalde, María Luz¹ (AUTHOR), Cuello, Karen³ (AUTHOR), Iglesias, Diego¹ (AUTHOR), Pizarro, Rodolfo¹ (AUTHOR)
Source:	Medicina (Buenos Aires). sep/oct2025, Vol. 85 Issue 5, p978-990. 13p.
Subjects:	OBESITY, CARDIOLOGY, DRUG therapy, BODY mass index, BARIATRIC surgery, TREATMENT delay (Medicine), BEHAVIOR modification
Geographic Terms:	ARGENTINA
Abstract (English):	Introduction: Obesity is a major risk factor for cardio vascular 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 obe sity management. Materials and methods: We conducted a cross-sec tional survey using a web-based questionnaire. The survey was distributed via WhatsApp employing con venience and snowball sampling among cardiologists practicing in Argentina. Results: Of the 380 questionnaires sent, we re ceived 363 responses. A total of 130 cardiologists (35.8%) were unaware of the normal body mass index (BMI) range. Most respondents did not routinely as sess 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 physi cal 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 im provements in cardiologists' training and promotion of proactive behaviors in obesity management, as sig nificant gaps in knowledge, diagnosis, and therapeutic interventions were identified. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Introducción: La obesidad constituye un factor de riesgo mayor para las enfermedades cardiovasculares. Si bien los cardiólogos desempeñan un rol clave en el manejo de estos pacientes, no está claro en qué medida participan en el abordaje diagnóstico-terapéutico de la obesidad. El objetivo de este estudio fue evaluar las prácticas y enfoques de los cardiólogos en Argentina en relación con el manejo de la obesidad. Materiales y métodos: Se realizó una encuesta trans versal mediante un cuestionario en línea, distribuido por WhatsApp con un muestreo por conveniencia y bola de nieve entre cardiólogos en ejercicio en Argentina. Resultados: De los 380 cuestionarios enviados, se obtuvieron 363 respuestas. Un total de 130 cardiólo gos (35.8%) desconocían el rango normal del índice de masa corporal (IMC). La mayoría de los encuestados no evaluaba rutinariamente el peso (n = 293; 80.7%) ni el perímetro de cintura (n = 330; 90.9%), y solo 101 (27.8%) calculaba sistemáticamente el IMC. En cuanto a las in tervenciones sobre estilo de vida, 218 cardiólogos (60.1%) recomendaban siempre una alimentación saludable, y 306 (84.3%) promovían consistentemente la actividad física. El tratamiento farmacológico nunca había sido prescripto por 207 encuestados (57.0%), y 237 (65.3%) nunca habían indicado cirugía metabólica. Los agonistas del receptor del péptido similar al glucagón tipo 1 fueron el tratamiento más frecuentemente prescripto, reportado por 123 cardiólogos (78.9% de quienes indicaron tratamiento farmacológico). En el análisis multivariado, tener >10 años de experiencia se asoció significativamente con la prescripción de tratamiento farmacológico (OR 2.51; IC 95% 1.52-4.17) y con la derivación a cirugía metabó lica (OR 2.37; IC 95% 1.41-3.96). El ejercicio profesional en el ámbito privado se asoció con la prescripción de tratamiento farmacológico (OR 2.97; IC 95% 1.04-8.49), mientras que los cardiólogos de sexo masculino presen taron mayor probabilidad de derivar pacientes a cirugía metabólica (OR 1.72; IC 95% 1.02-2.92). Discusión: Resulta imprescindible mejorar la forma ción de los cardiólogos y promover conductas proactivas en el abordaje de la obesidad, dado que se identificaron brechas relevantes en conocimientos, diagnóstico e in tervenciones terapéuticas. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina
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Description
Abstract:	Introduction: Obesity is a major risk factor for cardio vascular 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 obe sity management. Materials and methods: We conducted a cross-sec tional survey using a web-based questionnaire. The survey was distributed via WhatsApp employing con venience and snowball sampling among cardiologists practicing in Argentina. Results: Of the 380 questionnaires sent, we re ceived 363 responses. A total of 130 cardiologists (35.8%) were unaware of the normal body mass index (BMI) range. Most respondents did not routinely as sess 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 physi cal 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 im provements in cardiologists' training and promotion of proactive behaviors in obesity management, as sig nificant gaps in knowledge, diagnosis, and therapeutic interventions were identified. [ABSTRACT FROM AUTHOR]
ISSN:	00257680