Social determinants of motivation to lose weight among literate obese patients: A qualitative study

Abstract

Background: The study of motivation is central to understanding and identifying patients who are likely to benefit from obesity interventions. Previous studies have demonstrated the efficacy of an outpatient counselling technique in improving motivation to change among literate obese patients. The reasons for this demonstrated efficacy needs to be explored to guide policy and practice of obesity interventions. Methods: A total of 18 obese individuals were recruited by purposive sampling into three groups of six individuals each matched for Readiness to Change (RTC) group based on URICA Score, age group and gender. Focus group discussions using open-ended questions to elucidate which factors could potentially be correlated with participants’ motivation, were moderated between July and October 2012. Data was recorded manually and with an MP3 recorder. Thematic analysis was used to generate themes and a derived model in January 2013. Results: The key themes generated from the focus group discussion include: Pressure from family, friends and society; Dressing, stigmatization and self-esteem; Recognition of risk factors for diseases; Counselling by the physician: Economic factors: and having a weight loss programme in the hospital. Conclusion: Mixed extrinsic and intrinsic factors play a role in motivation to lose weight among literate obese patients in a primary care setting. Extrinsic factors (peer, family and societal pressure; cash incentives; counselling by physician; and hospital weight loss programme) were however predominant. These findings have implications for clinicians involved in weight management programmes, and policy makers seeking public health interventions for obesity prevention need to consider interventions targeted on extrinsic motivations.