Community‐based care needs for adults with class III obesity before and after tertiary weight management: An exploratory study

Abstract

ObjectiveClass 3 obesity (severe obesity) is defined by a body mass index ≥40 kg/m2. Tertiary weight‐management programs (WMPs) are hospital‐based multidisciplinary services that aim to support individuals with severe obesity. Severe shortage of WMPs has led to waitlists and pressure on clinicians to discharge patients. Community obesity management often fails to support patients in maintaining weight loss/health gains. This study aimed to explore the needs of patients for community‐based obesity care.MethodsA qualitative study was undertaken via a tertiary WMP in Sydney, Australia. Semi‐structured interviews/focus groups explored perceptions of purposively sampled patients and their clinicians on the community‐based support needs of people with severe obesity. Data were audio‐recorded, transcribed verbatim, and then thematically analyzed.ResultsEleven patients and seven clinicians were interviewed. Four themes were identified: the importance of accountability and motivation to maintain weight‐loss/health gains; limitations within community‐based obesity management for those with severe obesity; perspectives on structured community programs for patients transitioning into/out of tertiary WMPs; and impact of mental health, stigma, and social isolation on engagement with community‐based services.ConclusionsCommunity‐based programs are needed to support those awaiting access to tertiary WMPs and to help maintain health gains once discharged. Such programs should address issues of social isolation and integrate with current models of tertiary metabolic and primary health care.

Predictors of Mental Health Outcomes in a Multidisciplinary Weight Management Program for Class 3 Obesity

“…Despite these limitations, due to the simplicity and convenience of data collection, this study used BMI as a measure of obesity. Previous qualitative research has also suggested that mental health, stigma, and social isolation impact engagement with community-based services [47]. While the baseline QoL scores have been used to try and predict weight loss after bariatric surgery [48], to the author's knowledge, there is no current research on the psychological predictors of mental health outcomes following non-surgical weight management interventions.…”