Dietitians' Perceptions of the Obesity Care Pathway: Qualitative Insights on Access, Follow‐Up, and Referral of Patients Living With Obesity

OBJECTIVES: With obesity management medications being used more widely, it is important to understand the role of the dietitian in the obesity care pathway. This study examined primary-care dietitians' perspectives on the various phases of the obesity care pathway, from patients living with obesity (PwO) accessing nutritional services through monitoring and referral. METHODS: In this qualitative study, first-line dietitians in Flanders, Belgium, between March, 2025 and June, 2025, were invited to participate. Participants were interviewed, and data were transcribed and analysed using thematic analysis. The first section of the semi-structured interview guide focused on how PwO typically access nutrition therapy, how dietitians monitor and follow up with PwO, and the criteria they use for referral. Lastly, dietitians were asked about their collaboration with other healthcare professionals involved in the care of PwO. RESULTS: Twelve dietitians were interviewed before data saturation was reached. PwO accessed dietetic care mainly through self-initiative or medical referral, though referrals from general practitioners (GPs) were reported as limited. Monitoring and follow-up varied widely in duration and evaluation tools, while barriers such as limited patient motivation, time constraints, and limited reimbursement for dietetic care hindered continuity of care. Dietitians highlighted the need for referral guidelines, digital tools to support interprofessional communication, educational initiatives on interprofessional collaboration, and a central care coordinator to improve obesity care. CONCLUSION: This qualitative study examined primary-care dietitians' experiences across the obesity care pathway, from patient access to monitoring and referral. Dietitians highlighted limited referrals from GPs as well as variability in the duration and monitoring practices of nutritional therapy. Clear treat-to-target and referral guidelines could reduce reliance on individual clinical judgement, promote coordinated care and prevent delays in effective multidisciplinary care.