Perspectives and Experiences of Adult Patients With Obesity in Dietetic Primary Health Care: A Qualitative Study in the Netherlands

Background: 

Obesity is defined as a chronic, relapsing disease, characterised by its persistence and the frequent recurrence of weight gain following weight loss. It is linked to chronic diseases and reduced quality of life. Sustainable weight loss requires long-term dietary and behavioural changes. Dietetic treatment outcomes vary per patient, leading to differing success rates and effectiveness. Although understanding patient experiences is crucial for designing effective, patient-centered strategies, little is known about their lived experiences. This study aimed to obtain a better understanding of the perspectives and experiences of patients with obesity receiving dietetic treatment in primary health care in the Netherlands. 

Methods: 

This qualitative interpretive study included 26 patients with obesity who were consulting or had consulted a dietitian. We performed purposeful sampling to ensure a sample diverse in socio-cultural background, region, age and health literacy. Semi-structured interviews were conducted using a predefined topic guide, with room for flexibility to explore emerging topics. We analysed the interview data using reflexive thematic analysis as described by Braun and Clarke. 

Results: 

Four interconnected themes were constructed from what patients named to be important in dietetic treatment: (1) personalised treatment as a foundation for success, including feeling heard and receiving responsive and adaptive treatment (2) the personal impact of the dietitian on treatment, through the dietitian's attitude, professionalism, and background; (3) a personalised and holistic approach for lasting change, including clarity about the dietitian's ways of working, motivational and emotional support, attention to life context and guidance in developing sustainable habits; and (4) tailored and accessible advice, focusing on practical tools, understandable information, and consistency of advice. 

Conclusion: 

This study highlights that successful dietetic treatment for adults with obesity depends on personalised support, a strong patient–dietitian relationship, and holistic attention to psychological and behavioural factors. Clear communication, involvement from the start, and practical, tailored advice help patients comply with treatment and apply recommendations in daily life. Findings emphasise the importance of aligning dietetic treatment with individual patient needs and expectations.