Nearly 40 percent of American adults and 20 percent of children carry enough extra weight to warrant a diagnosis of obesity. That’s the highest obesity rate among the world’s affluent nations, and it’s already shortening Americans’ lifespans by driving up rates of diabetes, heart disease, stroke, cancers, arthritis and dementia.

If that constitutes an urgent threat to the nation’s health, you’d scarcely know it from reading the results of a newly published survey called ACTION.

The new poll paints a picture of obese adults who are clueless and feel utterly on their own when it comes to losing weight and of physicians who are often too busy, too embarrassed or too ill-equipped to help them.

The nation’s obesity crisis has been roughly four decades in the making. The ACTION report is a humbling reminder that, at this rate, it will not be quickly reversed.

ACTION stands for Awareness, Care and Treatment in Obesity Management. During two weeks in the fall of 2015, survey-takers assessed how obesity was viewed, experienced and treated by 3,008 obese adults and 606 doctors who provide medical care to such patients.

What they found is a medical establishment still navigating its role in addressing obesity, and a population of patients not yet sure they need – or have a right to demand – help in shedding extra pounds. The results were presented at this week’s meeting of the Obesity Society and published in the journal Obesity.

The American Medical Association formally recognized obesity as a “disease” in June 2013. That medical consensus has not fully penetrated the ranks of doctors: Only 80 percent said they believe obesity is a disease, and only 72 percent said they have a responsibility to actively contribute to their patients’ weight loss.

Awareness among patients with obesity was even worse. Some 65 percent of obese patients said they believed obesity was a disease that warranted compassionate treatment. But only 54 percent said a person’s weight would affect his or her future health “a lot” or an “extreme amount.”

Strikingly, only half of those with obesity actually perceived themselves as “obese” or “extremely obese.” Among the rest, 48 percent considered themselves “overweight” and 2 percent believed they were “normal weight.”

Small wonder perhaps, since only 71 percent said they had discussed their weight with their doctor in the last five years, and only 55 percent reported they had been diagnosed with obesity.

Just 24 percent were offered follow-up care meant to treat their obesity, and 18 percent had committed to a weight-loss plan.