Background: In 2014-15, 63.4% of Australian adults were overweight or obese, with 25% categorized as obese. Internationally, people with obesity are reported to experience inadequate quality of care, increased length of stay, more adverse events and higher costs of care. There are unique challenges associated with ensuring this cohort is provided with safe care which promotes their personal dignity. The aim of this study was to describe the experience of clinical leaders and managers of care provision to people with obesity, during inpatient admissions to an Australian public health service.Methods: A purposive, convenience sampling method was utilised, resulting in the recruitment of 17 participants. Data was collected via semi-structured interviews in the workplace, which were all digitally recorded for verbatim transcription. All data was subjected to thematic analysis, with identified codes reorganised into overall themes.Results: Five overarching themes were identified, four of which are discussed in this publication. The main themes and subthemes were (I) resource allocation (incorporating inequality, economic resources, human resources and physical resources); (II) service context (incorporating understanding 'bariatric', physical/ built environment, staff knowledge and skills, and organisational culture; (III) care transitions (incorporating transitions in care, communication and organisational processes; and recommendations for best care for people with obesity. Conclusions:The experience and perceptions of participants reflect the issues they prioritised in their respective roles, and confirm that providing care for people with obesity has significant policy and practice implications. These issues cannot be considered in isolation, with significant overlap and interdependence was evident. Participants also described the positive outcomes and progress which could be achieved when organisations take direct action to improve the care they provide to people with obesity.

While obesity is recognized as a key global public health issue, there has been no research to date on the perceptions of care for people with this condition held by individuals in positions of organizational power. The aim of this study was therefore to describe the perceptions and experiences of clinical leaders and managers of providing care to inpatients with obesity at a metropolitan public health service. This study applied an interpretative phenomenological analysis (IPA) approach to qualitative research, conducting interviews with 17 participants. Their perceptions of care for inpatients with obesity encompassed both their personal understanding as an individual, and their observations about the organizational, patient and carer perspectives. Three overall themes were identified: (1) the problem of inpatients with obesity, (2) inpatients with obesity as sources of risk and (3) personal and professional perceptions of inpatients with obesity. While clinical leaders and managers were aware of the potential impact of stigma and weight bias on care given to this cohort, elements of implicit bias, stereotyping, “othering” and ambivalence were frequently present in the data. Ongoing efforts to improve care for patients with obesity must therefore include efforts to address perceptions and attitudes at all organisational levels of the workforce.

While obesity is recognized as a key global public health issue, there has been no research to date on the perceptions of care for people with this condition held by individuals in positions of organizational power. The aim of this study was therefore to describe the perceptions and experiences of clinical leaders and managers of providing care to inpatients with obesity at a metropolitan public health service. This study applied an interpretative phenomenological analysis (IPA) approach to qualitative research, conducting interviews with 17 participants. Their perceptions of care for inpatients with obesity encompassed both their personal understanding as an individual, and their observations about the organizational, patient and carer perspectives. Three overall themes were identified: 1) The problem of inpatients with obesity, 2) Inpatients with obesity as sources of risk and 3) Personal and professional perceptions of inpatients with obesity. While clinical leaders and managers were aware of potential impact of stigma and weight bias on the care given to this cohort, elements of implicit bias, stereotyping, ‘othering’ and ambivalence were frequently present in the data. Ongoing efforts to improve care for patients with obesity must therefore include efforts to address perceptions and attitudes at all organisational levels of the workforce.

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