Barriers to losing weight for women attending group visits in primary care: A qualitative exploration using in-depth interviews

Despite the accumulated evidence suggesting the positive aspects of using group visits in obesity, the number of qualitative studies that examine why and how the effects occur at an individual level is limited.
This qualitative study aimed to explore the experiences and perspectives of women who participated in group visits and had different weight loss outcomes in the programme.
Purposive maximum variation sampling was performed. Data collection and analysis were performed iteratively, and the data saturation method was used as a guideline for sample size. All participants who completed the group visits were approached, and finally, 20 individuals were included in the study. Semi-structured in-depth interviews were audio-recorded, transcribed verbatim, and analysed thematically using a phenomenological approach.
The mean age of the individuals was 38.5 ± 9.8 years, the education level ranged from incomplete-high school to university degree, and the weight changes were between +4.1% and −17.1%. Two main themes emerged from the thematic analysis revealing barriers: weight stigma (two sub-themes: internal and external stigma) and traumatic life events (three sub-themes: ‘loss of relatives,’ ‘childhood traumas,’ and ‘conflicting intimate partner relationships’).
Considering the barriers to weight loss efforts in this study, these issues need to be explicitly investigated before and during the group visits in addition to weight loss practices and behavioural changes.

尽管已有大量累积证据表明，在肥胖管理中采用团体就诊模式具备积极价值，但针对该模式为何能产生效果、以及效果如何在个体层面发挥作用的质性研究数量仍十分有限。
本项质性研究旨在探索参与过该项目团体就诊、且体重减轻效果存在差异的女性群体的体验与观点。
研究采用目的性最大差异抽样法。数据收集与分析以迭代方式开展，并以数据饱和法作为样本量确定的依据。
研究纳入所有完成团体就诊的参与者，最终纳入20名研究对象。研究采用半结构化深度访谈法，对访谈内容进行录音并逐字转录，随后以现象学方法开展主题分析。
研究对象的平均年龄为38.5±9.8岁，受教育程度从未完成高中学业至大学学历不等，体重变化幅度介于+4.1%至-17.1%之间。主题分析共提炼出两大揭示减重阻碍的核心主题：体重污名（含2个子主题：内部污名与外部污名）与创伤性生活事件（含3个子主题：“亲友离世”“童年创伤”与“亲密伴侣关系冲突”）。
鉴于本研究识别出的减重阻碍因素，在团体就诊开展前后及过程中，除减重实践与行为改变干预外，还需对上述问题进行明确的调研与干预。