Maximising the appeal of weight management services: Qualitative research

Commissioned by COI / Cross Government Obesity Team in November 2009, ESRO’s research on maximizing the appeal of weight management services took us to all corners of England. From Newcastle to Brighton, Norwich to Bristol, ESRO researchers met with numerous individuals, conducted workshops, and visited several weight management services producing case studies, films, and ethnographic narratives exploring the complex and emotive issue of weight management.  The research included a diverse range of demographic groups, including men, women, young people, and individuals from different ethnic backgrounds and of different income levels.

The research highlighted that weight remains a difficult and personal issue, made more complex by the interplay between long-term health issues (such as diabetes or arthritis) and key life events such as divorce, bereavement, job loss, accident or injury.   Equally difficult for some, was a gradual increase in weight over long periods of time accompanied by the realisation that whilst they once had been a ‘healthy size’, their weight had now reached unacceptable levels.

Weight management was often described as a never-ending battle, exhausting, and painful. Yet whilst acknowledging the deep seated concerns around the reason for weight gain, all of the respondents pointed out that weight loss, healthier living, and better eating acted as confidence boosters, empowering and enabling further change and better life choices. Such choices reinforced the respondents’ sense of self worth, enabling them to move past their own personal difficulties.

The full report highlights the level of motivation that exists amongst overweight and obese people to lose weight.  It also highlights the complexity of the barriers surrounding engaging with services.  Key findings include:-

·       For the majority of overweight people there is a strong desire to ‘be less fat’

·       Weight is an emotive issue and language used around weight and obesity can be a particularly sensitive area

·       Whilst measures such as ‘weight’ and BMI are useful in clinical settings they can lack personal relevance

·       More meaningful and empowering framings of ‘fatness’ include overall health, fitness, size and shape

·       It is clear that ‘one size does not fit all’ when it comes to weight management services

·       When designing and commissioning weight management services, it is important to take into account the motivators and barriers experienced by different population segments or user groups

·       Appealing weight management services need to find an appropriate balance of nutritional advice, exercise and support (different segments find different ‘components’ more spontaneously appealing)

·       Tailoring support around an individual’s ‘readiness to change’ is important in getting buy-in and ensuring that messages aren’t felt to be patronising or overwhelming.

People Segments

In the full report, we highlight that individuals often express frustration at the current services on offer, which they describe as unappealing, ‘for someone else’ and unreflective of their needs or experiences.

More specifically, broad differences of appeal emerged across different socio-demographic groups:

·       Male and female

·       Older and younger

·       More and less affluent

·       Size (e.g. overweight – morbidly obese)

In order to capture these differences more clearly, we have devised nine ‘People Segments’. Each segment outlines the broad differences between groups, highlighting a diverse range of motivations, barriers and ideals in terms of weight management services.  

The tables overleaf represent an overview of the nine segments.

Women

Men