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. 2024 Jun;27(3):e14098.
doi: 10.1111/hex.14098.

'Beyond the Scale': A Qualitative Exploration of the Impact of Weight Stigma Experienced by Patients With Obesity in General Practice

Leona Ryan  1 , Fiona Quigley  2 , Susie Birney  3 , Michael Crotty  4 , Owen Conlan  5 , Jane C Walsh  1
Affiliations

'Beyond the Scale': A Qualitative Exploration of the Impact of Weight Stigma Experienced by Patients With Obesity in General Practice

Leona Ryan et al. Health Expect. 2024 Jun.

Abstract

Objective: Obesity is a complex, chronic, relapsing disease that requires an individualised approach to treatment. However, weight stigma (WS) experienced in healthcare settings poses a significant barrier to achieving person-centred care for obesity. Understanding the experiences of people living with obesity (PwO) can inform interventions to reduce WS and optimise patient outcomes. This study explores how patients with obesity perceive WS in general practice settings; its impact on their psychological well-being and health behaviours, and the patients suggestions for mitigating it.

Methods: In-depth semistructured interviews were conducted with 11 PwO who had experienced WS in general practice settings in Ireland. The interviews were conducted online via Zoom between May and August 2023; interviews lasted between 31 and 63 min (M = 34.36 min). Interviews were audio-recorded, transcribed verbatim and analysed using inductive reflexive thematic analysis.

Results: Three overarching themes specific to participants' experience of WS in general practice were generated: (1) shame, blame and 'failure'; (2) eat less, move more-the go-to treatment; (3) worthiness tied to compliance. A fourth theme: (4) the desire for a considered approach, outlines the participants' suggestions for reducing WS by improving the quality of patient-provider interactions in general practice.

Conclusion: The findings call for a paradigm shift in the management of obesity in general practice: emphasising training for GPs in weight-sensitive communication and promoting respectful, collaborative, and individualised care to reduce WS and improve outcomes for people with obesity.

Patient or public contribution: PPI collaborators played an active and equal role in shaping the research, contributing to the development of the research questions, refining the interview schedule, identifying key themes in the data, and granting final approval to the submitted and published version of the study.

Keywords: general practice; obesity; patient–provider; qualitative; weight stigma.

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Conflict of interest statement

Michael Crotty reports honoraria for educational events or conference attendance from Novo Nordisk and Consilient Health and was a member of a Novo Nordisk advisory board. He is a member of the Irish ONCP Clinical Advisory Group and ASOI. Michael is the co‐founder and clinical lead of ‘My Best Weight Clinic’. Susie Birney reports funding to ICPO from the HSE, Novo Nordisk, and the European Coalition for People Living with Obesity (ECPO) and consulting fees or honoraria from Diabetes Ireland, ECPO, and Novo Nordisk. Susie is the Executive Director of ICPO and the Secretary of ECPO. The other authors declare no conflicts of interest.

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