Barriers to Lifestyle Modification and Willingness to Join Weight Loss Programs Among Overweight or Obese Adults in Saudi Family Medicine Clinics

Background Obesity is a growing public health concern in Saudi Arabia, with increasing prevalence and related comorbidities. Lifestyle modification is key to treatment, yet patient-level barriers and readiness to engage in structured weight management programs remain underexplored in primary care. Objective The aim of this study was to examine perceived barriers to lifestyle change, past weight loss attempts, and factors associated with willingness to join structured weight loss programs among overweight or obese adults attending family medicine clinics in Saudi Arabia. Methods A cross-sectional study was conducted from March to May 2025 at four urban family medicine clinics. Adults aged ≥18 years with a BMI of ≥25 kg/m² were consecutively recruited. Participants completed a questionnaire on demographics, weight loss attempts, barriers, information sources, and willingness to participate in structured programs. Bivariate analyses and multivariable logistic regression identified factors associated with weight loss attempts and willingness to join programs. Results Among 312 participants, 199 (63.8%) were female. Most were aged 30-49 years (167 [53.5%]). Weight loss attempts in the past year were reported by 213 (68.3%). Common barriers included lack of motivation (219 [70.2%]), limited time to exercise (213 [68.3%]), and cost of healthy food (205 [65.7%]). Only 138 (44.2%) recalled physician counseling on weight management. In bivariate analyses, female sex (147 of 199 women [73.9%] vs. 66 of 113 men [58.4%], P=0.004) and university/postgraduate education (139 of 181 [76.8%] vs. 74 of 131 [56.5%], P<0.001) were associated with weight loss attempts. Multivariable logistic regression showed female sex (adjusted OR 1.62; 95% CI, 1.01-2.60; P=0.045), university/postgraduate education (adjusted OR 2.10; 95% CI, 1.28-3.46; P=0.003), and identifying a physician as the main information source (adjusted OR 2.44; 95% CI, 1.47-4.06; P<0.001) were independently associated with willingness to join a structured weight loss program. Conclusions Most overweight or obese adults attending family clinics in Saudi Arabia have attempted weight loss but face multiple barriers, including motivation, time, and cost. Physician engagement and higher education levels increase readiness to participate in structured programs. Tailored interventions addressing these barriers are critical to improving obesity management in primary care.