One size does not fit all: Qualitative interviews with individuals with overweight or obesity and healthcare providers on navigating and supporting weight management

Background: Obesity and overweight are significant health concerns in the United States (US) with an expanding number of treatment options. Patients face challenges of a complexity of options, systemic access barriers, and need for support from healthcare providers (HCPs). The goal of this study was to qualitatively assess the experience of individuals with overweight or obesity and HCPs navigating weight management, strategies including obesity medications (OMs), and the support and motivation needed for sustained success. Methods: This cross-sectional qualitative study included adults with overweight or obesity with a desire to lose weight (n = 40) and HCPs (n = 25) in the United States. Trained moderators conducted in-depth one-on-one interviews in English or Spanish. Four independent coders analyzed transcripts for each group (Cohen's kappa>0.7 for each). Narrative themes were developed summarizing key findings. Results: Four key themes were formed: (1) Participants felt overweight and obesity should be treated like other chronic diseases (individuals with overweight or obesity: 88%; HCPs: 92%). (2) Approaches to managing and discussing weight with HCPs are highly individualized. Individuals most commonly used diet (81%), exercise (61%), and OMs (28%). HCPs prioritized diet and physical activity. All HCPs recommended OMs for some patients but noted systemic access barriers such as limited insurance coverage. Individuals wanted more information on OMs, especially safety and tolerability, despite most HCPs (88%) reporting sharing this information. (3) Supporting and motivating individuals through their weight-loss journey is critical; HCP support is also critical. (4) Modifying systemic barriers could aid weight loss, including more proactive HCP discussions, more education, and improved OM access. Conclusion: This qualitative study demonstrated that approaches to managing and discussing weight are highly individualized. Support and motivation are crucial to maintain long-term success. Access to treatments and HCP support represent key opportunities for improvement for individuals seeking to achieve sustained weight loss.