# Barriers to Weight Loss Among Inner-City Adults Seeking Obesity Treatment at an Academic Weight Management Program

## TL;DR

This study explores the challenges and supports for weight loss among inner-city adults seeking obesity treatment, emphasizing the role of family, cost, and accountability.

## Contribution

The study provides novel insights into barriers and facilitators of weight loss in underserved inner-city populations through qualitative focus groups.

## Key findings

- Family support and personal motivation were key facilitators for weight loss.
- Cost and time were identified as major barriers to successful weight management.
- Participants recommended peer-led support groups to improve accountability.

## Abstract

Objective

Obesity is an epidemic in US inner-city minority communities, which experience disproportionately higher rates of obesity and its preventable complications. There is limited published literature regarding weight management programs, particularly among inner-city academic centers caring for underserved patients. The primary purpose of this study was to improve our understanding of the patient experience with obesity by exploring the weight management journey, including barriers and facilitators for weight loss in patients seeking medical treatment for obesity at an inner-city, academic weight management center.

Methods

Three focus groups were conducted using a semi-structured discussion guide and qualitative study design. Participants, 18 years and older, were recruited from a single inner-city weight management program. A total of 18 participants attended one of three total focus groups. An interview guide was designed and utilized to elicit the experience of inner-city adult patients in the areas of their personal weight journey, where these patients obtain information about nutrition and physical activity, and which interventions participants would find most helpful to achieve successful weight loss. Investigators identified recurring themes from transcripts and coded remarks to themes from within and across the focus groups.

Results

Family support and personal motivation were important themes contributing to weight loss, while cost and time were significant barriers. Participants reported that the internet was their main source of information about weight management, which was supported by advice given by their physician or nutritionist. The primary intervention that participants recommended was improved accountability through support groups as part of a weight management program.

Conclusions

The findings of our qualitative research study highlight specific aspects of weight management which most highly affect weight journeys, including factors such as family support, the need for accountability, and challenges such as food, time, and mental health stressors, in turn allowing providers to prioritize these aspects when treating and guiding patients in weight management programs. These findings also provide important information to the leadership of weight management programs to guide future interventions; our institution aims to incorporate peer-led support groups to enhance accountability and communication with providers.