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Updated: Dec 29, 2025
Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
Cooperation behaviour of primary care paediatricians: facilitators and barriers to multidisciplinary obesity
Franca Brüggen1, Paul Gellert1, Nadja-Raphaela Baer1
1Charité - Universitätsmedizin Berlin, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany.
Insights
Multidisciplinary management of childhood obesity requires cooperation among healthcare professionals. This study identifies key barriers and facilitators for primary care pediatricians in Germany, offering insights to improve obesity care strategies.
Area of Science:
- Pediatrics
- Public Health
- Healthcare Management
Background:
- Childhood obesity is a growing concern requiring multidisciplinary management.
- Primary care pediatricians are crucial in tackling childhood obesity through collaboration.
- Understanding facilitators and barriers to multidisciplinary cooperation in ambulatory care is essential.
Purpose of the Study:
- To investigate the facilitators and barriers to multidisciplinary cooperation in childhood obesity management by primary care pediatricians in Germany.
- To identify factors influencing cooperation patterns between pediatricians and external healthcare partners.
Main Methods:
- A nationwide, cross-sectional survey was conducted among German primary care pediatricians.
- A questionnaire, developed from expert interviews, assessed cooperation with various external partners.
- Statistical analysis, including multiple imputation for missing values, was used to associate individual and structural factors with cooperation patterns.
Main Results:
- A response rate of 33.3% (2024/6081) was achieved.
- 40.8% of pediatricians disengaged from obesity prevention due to perceived inefficacy; 90.4% cited lack of financial reimbursement.
- Barriers included a high proportion of patients with migration background, lack of time, and service availability. Facilitators included a broader professional role conception, older age, female gender, higher patient obesity rates, and urban/socially strained practice locations.
Conclusions:
- Low perceived self-efficacy and insufficient financial reimbursement are significant challenges for German pediatricians in obesity management.
- Individual and structural factors play a crucial role in cooperation behavior, offering avenues for improving multidisciplinary childhood obesity management.
Background:
Multidisciplinary management of obesity by primary care paediatricians, providing a promising approach to tackle childhood obesity includes cooperation with other health care professionals. However, facilitators for and barriers to multidisciplinary cooperation in ambulatory care are not yet well understood and are investigated in the present study.
Methods:
A nationwide, cross-sectional survey of 83% of German primary care paediatricians was conducted, using a questionnaire based on qualitative expert interviews. Frequency of paediatricians' cooperation with external partners (i.e. nutrition counsellors; sports groups; interdisciplinary obesity centres; inpatient rehabilitation centres; and endocrinologists) was assessed. Individual and structural factors were associated with cooperation patterns. Missing values were addressed using multiple imputation.
Results:
Out of the 6081 primary care paediatricians approached, 2024 (33.3%) responded. Almost half of the respondents (40.8%) stated that they disengaged in the field of obesity prevention due to perceived inefficacy. Lack of financial reimbursement for consultation was agreed on by most of the respondents (90.4%). Identified barriers to cooperation included: higher proportion of patients with migration background, lack of time and available services. A more comprehensive conception of the professional role regarding overweight prevention, higher age, female gender, higher proportion of overweight/obese patients and practice location in urban or socially strained areas surfaced as facilitators for cooperation.
Conclusion:
Low-perceived self-efficacy in obesity management and insufficient financial reimbursement for consultation are commonly stated among German paediatricians. For cooperation behaviour, however, other individual and structural factors seem to be relevant, which provide indications on how multidisciplinary childhood obesity management can be improved.
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