Weight-management: understanding services and public needs to inform future programme development

Abstract

Overweight and obesity are major health challenges worldwide, often associated with morbidity and mortality. In Northern Ireland (NI), 65% of adults are living with overweight and obesity. Rising obesity levels have been accompanied by an increase in negative attitudes towards people living with obesity, including weight stigma. Systematically mapping adult obesity-policies and weight-management services in NI could help identify gaps in coverage/provision. Understanding the motivations, preferences and experiences of adults living with obesity is also an important consideration in developing appropriate interventions. The overall aim of this thesis was to comprehensively understand obesity-related policies, weight management services, public needs and weight stigma in NI to inform future programme development. This involved: a) Systematically mapping obesity-related policy actions/services for adults in NI using the Behaviour Change Wheel b) Investigating public views about obesity and regarding experiences of weight stigma/discrimination in adults; c) Exploring public perceptions relating to obesity policies/personal experiences of maintaining a healthy weight in adults, involving a qualitative framework analysis of barriers and enablers; d) Quantitatively assessing the weight management preferences of NI adults living with obesity including priorities for future programme development and; e) Conducting Personal and Public Involvement activities with adults with lived experience of overweight/obesity in NI to aid the future development of a weight management intervention.

This research highlighted that obesity services were largely prevention-focused with an over-reliance on education. Development of weight management options are recommended within a flexible obesity-care pathway. The prevalence of weight stigma/discrimination on the Island of Ireland, suggested that targeted education about the causes of obesity to reduce weight stigma in society is warranted. Distilling the PhD findings along with PPI representatives helped create a strong basis to develop a future weight management intervention for adults, informed by formative research relevant to the UK/NI obesity context.

Thesis is embargoed until 31st July 2024.

Date of Award	Jul 2023
Original language	English
Awarding Institution	Queen's University Belfast
Sponsors	Northern Ireland Department for the Economy
Supervisor	Jayne Woodside (Supervisor), Laura McGowan (Supervisor) & Helen Croker (Supervisor)