Exploring the lived experience of tier two weight management services in the UK: A qualitative systematic review [abstract only]

Obesity is a global health epidemic with many attempts to address the rising prevalence. Lifestyle weight management services – typically focussing on dietary and physical activity interventions – have been the backbone of much obesity treatment in the UK. Whilst producing modest weight loss, these services fail to promote sustained weight loss maintenance, largely due to placing onus on the individual to enact behaviours (e.g., “eat less and move more”) that do not reflect the complex nature of obesity. This systematic review synthesised evidence on the experience of adult lifestyle weight management services in the UK, exploring service user motivations for joining services and experience in the context of weight loss maintenance. Four databases were searched (Web of Science, CINAHL, Science Direct and Google Scholar) resulting in 46,050 records. Following screening, a total of 37 were included in the present review. These articles highlighted health as a powerful motivator for service uptake and engagement. The services increased users’ weight loss capability by creating a physically enabling and motivational social environment, with many barriers to access removed by online delivery (e.g., during COVID-19). However, users expressed reliance on accountability, social encouragement and relatedness for motivating engagement and achieving ‘successful’ weight loss. This reliance on programmes is a particular concern for weight loss maintenance, given many users are expected to maintain weight loss independent of the services. Capitalising on digital service possibilities may offer cost-effective solutions to physical accessibility barriers and a novel way of providing ongoing social support for weight loss maintenance.