# Understanding How Patient Experiences of Support While Attending a Weight Management Service Impacts Engagement, Dropout and Retention: A Semi‐Structured Interview Study

## TL;DR

This study explores how different types of support during weight management services affect patient engagement, dropout, and retention.

## Contribution

The study identifies specific factors, such as peer support and clinician-patient rapport, that influence patient retention in weight management programs.

## Key findings

- Peer support and positive group dynamics help patients feel less isolated and more engaged.
- Consistent clinician-patient relationships and empathetic communication improve retention.
- Lack of family support or barriers to clinician communication can lead to frustration and dropout.

## Abstract

Patient retention underpins the success of weight management services, but they often face high dropout rates. This study aimed to explore patients' experiences of support during their attendance at a weight management service, and how it impacted on engagement, dropout and retention.

Thirty‐seven patients from an NHS weight management service participated in semi‐structured interviews conducted either face‐to‐face or by telephone. An open‐ended question explored participants' perspectives on the need for support during weight management, aiming to understand how support affects retention. Interviews were audio‐recorded, transcribed verbatim, and analysed thematically.

Peer support and a positive group dynamic in weight loss interventions enhanced engagement by harnessing the value of shared experiences, helping some patients overcome feelings of isolation. Positive patient‐clinician interactions, based on understanding and free from judgment, also enhance engagement. However, clinician changes during interventions risks undermining supportive bonds. Support from family and friends provides valuable emotional and motivational support, however, the absence of such networks can exacerbate isolation. Barriers to communicating with clinicians outside of appointments can frustrate patients, in contrast to experiences of commercial weight loss groups where participants have direct access to group leaders for support.

The support needs of patients with obesity attending weight management services vary considerably. Drawing on patient experiences can inform strategies to tailor support provision to better meet individual patient needs and enhance patient retention.

Clinicians influence retention by developing trust and rapport with patients and avoiding clinician changes during treatment pathways.Clinicians should seek to build rapport with patients built on empathy and understanding, and free from judgement, which is crucial for continued engagement for some patients.Effective management of group cohesion and disruption by group programme facilitators is crucial for harnessing peer support.

Clinicians influence retention by developing trust and rapport with patients and avoiding clinician changes during treatment pathways.

Clinicians should seek to build rapport with patients built on empathy and understanding, and free from judgement, which is crucial for continued engagement for some patients.

Effective management of group cohesion and disruption by group programme facilitators is crucial for harnessing peer support.