Between Empathy and Control: Nurses’ Experiences of Providing Obesity Care in a Tertiary Hospital

Caring for people living with obesity requires attention to eating, weight, emotional needs, and the therapeutic relationship. This study explored how nurses understand obesity care in a specialized outpatient clinic within the Servicio de Endocrinología y Nutrición (Endocrinology and Nutrition Department). An interpretive qualitative study was conducted at a tertiary hospital in Tenerife, Spain. Six nurses participated in semi-structured interviews conducted between August and October 2025. Interviews were audio-recorded, transcribed, and analyzed using reflexive thematic analysis, with reporting guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ). Four interrelated themes were developed: the therapeutic relationship based on trust, empathy, and nonjudgment; support versus control; nurses’ perceptions of patients’ experiences of guilt, shame, and weight stigma; and the nurse as a source of support in a resource-constrained context. Participants sought to provide person-centered care, although practice remained organized around weight monitoring, behavioral supervision, and goal attainment. They also described emotional labor and frustration when psychological and social needs exceeded available resources. Participants described nursing care for people living with obesity as extending beyond dietary education, while empathy coexisted with weight-centered practices and attributions of individual responsibility. The findings suggest the potential value of specific training, stigma-sensitive communication, and interdisciplinary support.