New research indicates supportive networks and stigma-free care are key to engagement in obesity treatment
A new open-access review in Obesity Reviews draws together evidence from 38 reviews on how children, adolescents and adults experience weight management treatment. It finds that supportive networks and stigma-free care are central to engagement, and that the lived experience of people receiving obesity medications has yet to be studied at review level.
Understanding how people experience obesity treatment is essential to designing care that works. A new umbrella scoping review, published open access in Obesity Reviews, brings together published review evidence on the lived experience of children and adults with overweight or obesity who take part in weight management interventions.
The review, led by Cecelia MacFarling Meure and colleagues at Deakin University and partner institutions, covered nutrition, physical activity, psychological, family-centred, sleep, pharmacological and metabolic bariatric surgery interventions.
What the researchers did
The team searched four major databases (Ovid MEDLINE, APA PsycINFO, CINAHL Complete and the Cochrane Library), identifying 4,183 records. Of these, 38 systematic and scoping reviews met the inclusion criteria:
- 13 described the experiences of children and adolescents and their caregivers
- 27 described the experiences of adults
- 1 covered all age groups
- 14 reported on experiences of metabolic bariatric surgery, two of them in adolescents
Findings were grouped by age and treatment type. Thematic analysis was supported by a large language model (Microsoft Copilot), following Cochrane guidance on responsible AI use in evidence synthesis, with every output checked by a researcher who had read all the included reviews.
Key findings
Support networks matter at every age.
Across all age groups and intervention types, support from family, friends, workplaces, schools and healthcare teams was key to starting, sticking with and maintaining weight management. For children and adolescents, family was central: families could encourage and model change, but could also create conflict and undermine efforts.
How care is designed and delivered shapes engagement.
People stayed engaged when programmes were accessible, individually tailored, collaborative, age-appropriate, culturally sensitive and free from judgement and stigma. Access to a range of services, including mental health support, and long-term follow-up helped people through their care.
Weight stigma remains a barrier.
Participants described stigma from family, peers, schools, the media and healthcare settings. People who experienced stigma in healthcare reported less trust in health professionals and often delayed or avoided appointments, which can lead to poorer health outcomes.
Weight loss does not resolve everything.
Improving body image was a common motivation for weight loss, yet body image concerns often continued afterwards. After surgery in particular, many adults described ongoing psychological distress. For some, surgery removed eating as a coping mechanism without addressing the underlying need. The authors describe body image as a neglected area in weight management interventions.
Adults describe weight management as lifelong.
Adults experienced weight management as a long-term process involving psychological adaptation, changes in identity, emotional regulation and managing pressures from their environment. Programmes that recognised success and progress, rather than focusing on perceived failure, supported motivation.
Implications for guidelines and practice
The authors note that clinical practice guidelines have historically not fully considered weight bias and stigma. They call for evidence-informed recommendations to reduce stigma to sit at the centre of guideline development, alongside person-centred care, respectful communication, non-stigmatising language and imagery, and training for health professionals.
Gaps in the evidence
The review identified important gaps. There were no reviews on the lived experience of people receiving pharmacological treatment for obesity in any age group, despite major recent changes in treatment options. Evidence on adolescents undergoing metabolic bariatric surgery was limited, as was evidence from Indigenous and other cultural populations.
The authors also note that the included reviews were not quality-assessed.
As the authors conclude: "as healthcare professionals, academics, and clinical practice guideline developers, we can do more to improve the experiences of people engaging in interventions to support weight management."
Read the full article
MacFarling Meure C, Salmon J, Peeters A, et al. The Lived Experience of Children and Adults with Overweight or Obesity Engaging in Weight Management Treatments: An Umbrella Scoping Review with Narrative Synthesis. Obesity Reviews. 2026.
This article is open access.
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Obesity Reviews is the official review journal of the World Obesity Federation, publishing reviews on all obesity-related disciplines.
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