Patient insights into the experience of trying to achieve weight-loss and future expectations upon commencement of a primary care-led weight management intervention: A qualitative, baseline exploration

Abstract

Introduction The long-term effects of interventions aiming to achieve substantial, sustainable weight loss maintenance have been disappointing. Most people regain their lost weight over time but some seem to be able to maintain their weight loss. We are following the experiences of patients over time prospectively. This study forms the baseline to provide insights into patient experiences prior to entering a primary care-led weight management intervention and their expectations going forward. Materials and methods We recruited 21 adult male and female patients of varying ethnicity with a BMI between 27.7kg/m2 and 48.4kg/m2 from a cohort of patients entering a primary care-led weight management intervention. Patients were offered video and audio interview options during the COVID-19 lockdown. In total, twenty chose the audio option, while one chose the video option. The interview format was semi-structured with room for individual exploration. Discussion We found that participants experienced feeling unable to control their weight and encountered a multitude of internal and external barriers to weight management. Some had supportive environments, while others experienced discouraging external influences. Though personal characteristics varied, motivations, goals and expected benefits were similar across this cohort. Most participants had previously experienced transient successful weight-loss attempts with varying approaches. COVID-19 was experienced as an opportunity or barrier for change. Conclusion This study illustrates the importance of gaining comprehensive insights into the diverse experiences patients encounter when trying to achieve weight loss. Personalized support taking into account individual experiences and circumstances may enhance long-term treatment outcomes. Future research into the complexities of weight management based on individual accounts can aid in the creation of improved treatment protocols.

Primary care-led weight-management intervention: qualitative insights into patient experiences at two-year follow-up

“…In order to capture the intricate nature of individual circumstances and account for the multidimensional aspects of this longitudinal study series, we utilized template analysis (Brooks et al, 2014 ) to incorporate the themes discovered in the systematic review, baseline study and one-year follow-up by the authors (Spreckley et al, 2021 , 2022 , 2023 ). As new themes emerged, they were added to the code tree.…”

“…Determining success enhancing and derailing aspects based on personal accounts of patients has the potential to inform and aid in the optimization of treatment protocols to enhance long-term outcomes. This study is building on a series of studies by the same authors including a systematic review, a baseline study and a 1-year follow up study with the same participant cohort (Spreckley et al, 2021 , 2022 , 2023 ). The discovered themes remained in line with the 1-year follow up themes, yet the importance and emphasis changed for all individuals throughout the cohort to varying degrees during the second year of the programme.…”

Primary care-led weight-management intervention: qualitative insights into patient experiences at one-year follow up

“…Participants for this study were purposefully recruited (Natvik et al, 2018 ) at the commencement of the baseline study (Spreckley et al, 2022 ). All participants except for one, who did not want to participate due to personal reason at the time of the interview period, agreed to take part in both follow-up studies, including this first follow-up after a year.…”

“…At the baseline, we aimed to achieve maximum diversity in the participant sample (Spreckley et al, 2022 ), but had some recruitment criteria, namely adult, BMI >25 kg/m2, fluent in English, never diagnosed with an eating disorder, assessed and cleared by a medical doctor from our practice to take part and wishing to lose weight. The group of participants included a broad representation of individuals with varying backgrounds, experiences and perspectives related to weight loss maintenance in a clinical setting.…”

“…This article offers insights, which we subjectively categorized into distinct factors and strategies, from the first follow-up interviews conducted after a year (12 months) as part of our interview series focused on identifying factors and strategies for successful long-term weight loss within a primary care-led weight-loss intervention. The perspective of the participants is central to this study, serving as a follow-up to the baseline research (Spreckley et al, 2022 ). The specific objective was to identify factors and strategies for successful long-term weight loss.…”