Physicians’ approaches to lifestyle modification for weight management: a protocol for a qualitative evidence synthesis

Overweight and obesity are highly prevalent worldwide and pose a serious public health issue, contributing to increased morbidity, mortality, and healthcare costs. Effective weight management improves health outcomes and quality of life, yet in routine clinical practice, implementation of existing guidelines remains inconsistent. Primary care physicians play a crucial role in the prevention and management of obesity, often serving as the first point of contact for patients. The 5A framework offers a structured, evidence-based approach for weight management in clinical settings. However, qualitative analysis of their implementation remains limited. This qualitative evidence synthesis aims to identify, appraise and synthesise available qualitative evidence on physicians’ weight management approaches within primary care settings using the 5A framework to identify factors that facilitate or hinder its effective implementation. A qualitative evidence synthesis will be conducted using Covidence software, focusing on peer-reviewed studies published from 1 January 2005 to 31 December 2025. Searches will be performed across four databases using targeted terms related to primary care physician, qualitative research, and weight management. Eligibility screening, critical appraisal, data extraction, and synthesis will be carried out independently by at least two reviewers. The synthesis will be guided by framework analysis, applying deductive coding mapped to the 5A framework. Findings will be appraised for methodological quality, and the Confidence in the Evidence from Reviews of Qualitative Research approach will be used to assess the level of confidence for each review finding. This qualitative evidence synthesis will provide a comprehensive overview of current primary care physician approaches to weight management mapped to the 5A framework, offering insights into how these approaches vary according to patient demographic, clinical, and health system factors. The synthesis will help identify contextual factors affecting the delivery of evidence-based weight management in primary care, highlight gaps between guideline recommendations and real-world practice, and pinpoint areas for targeted training, resource allocation, and policy development. Ultimately, the findings can inform strategies to enhance the implementation of structured weight management in primary care settings, leading to improved patient engagement and better health outcomes. This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO); registration number is CRD420251126971.