Most people with type 2 diabetes (T2D) also have obesity and the prevalence of both continues to increase. This study sought to understand approaches of endocrinologists (ENDOs) and primary care physicians (PCPs) in managing patients with both T2D and obesity to identify areas where physicians may benefit from continued education. A patient case-based survey assessing approaches to managing patients with T2D and obesity was fielded in October 2021, with responses from US-practicing ENDOs (n=181) and PCPs (n=350) . Survey questions included free response, multiple choice, and rating scales. Descriptive analysis was performed. When presented with a patient with poorly controlled T2D, obesity, and other clinical concerns (eg, elevated blood pressure (BP) , hyperlipidemia, and cigarette use) , improving HbA1c was among the top three goals in 93% of physicians, while BP control was a top goal for just over half and weight loss was a top goal for only 45%. In another patient presenting with T2D and unchanged BMI of 37 kg/m2, despite 6 months of lifestyle intervention, 9% of ENDOs and 15% of PCPs would continue current weight management without change. If the patient’s BMI been higher at 47 kg/m2, both ENDOs and PCPs were more likely to begin a weight loss medication and PCPs were more likely to defer management to a specialist. Most physicians (63%) agreed that effectively managing T2D leads to weight loss and 83% agreed that GLP-1 receptor agonists are effective for obesity. However, only half of ENDOs and 29% of PCPs have a certain percentage of body weight loss goal when managing obesity in patients with T2D. Further, 19% of ENDOs and 30% of PCPs reported that they trial diet, exercise, and behavioral modifications for 6 months or longer. Results show physicians may benefit from continuing education focused on the importance of addressing weight in combination with glycemic control for patients with T2D and obesity, and the benefits of pharmacotherapy as a component of weight management.


W.Cerenzia: None. S.Stacy: None. S.Wiley: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at