title: Primary care support for tackling obesity: a qualitative study of the perceptions of obese patients.
abstract: BACKGROUND
  Obesity has become a major public health issue and there is concern about the response of health services to patients who are obese. The perceptions of obese patients using primary care services have not been studied in depth.
  
  
  OBJECTIVE
  To explore obese patients' experiences and perceptions of support in primary care.
  
  
  METHODS
  Qualitative study with semi-structured interviews conducted in participants' homes.
  
  
  METHODS
  Five general practices contrasting in socioeconomic populations in Sheffield.
  
  
  METHODS
  Purposive sampling and semi-structured interviewing of 28 patients with a diverse range of ages, backgrounds, levels of obesity and experiences of primary care services.
  
  
  RESULTS
  Participants typically felt reluctance when presenting with concerns about weight and ambivalence about the services received. They also perceived there to be ambivalence and a lack of resources on the part of the health services. Participants showed a strong sense of personal responsibility about their condition and stigma-related cognitions were common. These contributed to their ambivalence about using services and their sensitivity to its features. Good relationships with primary care professionals and more intensive support partly ameliorated these effects.
  
  
  CONCLUSIONS
  The challenges of improving access to and quality of primary care support in tackling obesity are made more complex by patients' ambivalence and other effects of the stigma associated with obesity.
authors.affiliation: Department of Community, Ageing and Rehabilitation, School of Nursing and Midwifery, University of Sheffield, Sheffield. i.brown@sheffield.ac.uk
authors.forename: Ian
authors.initials: I
authors.lastname: Brown
authors.forename: Joanne
authors.initials: J
authors.lastname: Thompson
authors.forename: Angela
authors.initials: A
authors.lastname: Tod
authors.forename: Georgina
authors.initials: G
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001828:Body Image; D004739:England; D005194:Family Practice / Q000458:organization & administration / Q000592:standards*; D005260:Female; D006293:Health Promotion / Q000592:standards; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D010465:Perception; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012752:Shame; D012944:Social Support; D012959:Socioeconomic Factors