A study using semi-structured interview and Delphi survey to explore the barriers and enabling factors that influence access and utilisation of weight management services for people living with morbid obesity: A patient and professional perspective.

Abstract

A quarter of the United Kingdom's population are living with obesity, a disease that causes an estimated 30000 deaths each year. This coincides with an under-utilisation of weight management services across the country with the majority of patients with morbid obesity having no record of any weight loss intervention at all. This study explores the factors that influence patient access to weight management services. Expert opinion was obtained using semi-structured interviews and the Delphi methodology. Participants were selected from primary and secondary healthcare settings. Healthcare professionals (HCPs) had experience working in weight management services or in services dealing with obesity-related comorbidities. Patients had experience in attending a variety weight management services. Nineteen participants completed all aspects of the study. The main barriers included negative perceptions, low mood/depression, obesity not being considered as a serious disease, lack of access to services for housebound patients and disproportionate commissioning. Suggested facilitating factors to improve access included the education of all HCPs about obesity, improving HCP communication with patients, and broadening the number of HCP's that are able to refer to weight management services. Future services must prioritise the education of all HCPs and the public to combat the stigma of obesity and its impact on health. National commissioning guidelines in partnership with advocates of obesity should seek to streamline referral pathways, broaden referral sources and increase the availability of specialist services. Awareness of these factors when designing future weight management services will help to improve their utilisation.