Andrew Stokes, Jason M. Collins, Bethany F. Grant, Chia‐Wen Hsiao, Stephen S. Johnston, Eric M. Ammann, Kaitlyn M. Berry, Cindy Tong, Robin F. Scamuffa

Medical management of obesity can result in significant weight loss and reduce the burden of obesity-related complications. This report employs a new conceptual model to quantify engagement with obesity care and associated determinants in the US adult population. Engagement with obesity care was conceptualized as a cascade comprising 5 successive steps: perceiving oneself as overweight, desiring to lose weight, attempting weight loss, seeking care from a health care professional for obesity, and seeking care from a physician specifically. Among adults with obesity, 7.3% did not perceive themselves as overweight, 1.5% perceived themselves as overweight but had no desire to lose weight, 29.9% wanted to lose weight but did not try in the last year, 51.3% tried to lose weight but did not consult a health professional, and 6.4% sought help for weight loss from a health professional but not a physician, implying that 96.4% of the population with obesity had an unmet need for obesity care. This analysis provides new insight into the most common points along the cascade at which disengagement occurs and can inform efforts to improve uptake of obesity-related health care services.