Background: Many adults do not take up weight
management interventions even after apparently deciding to do so. Further
research about decision making prior to the intervention would be useful.
This paper presents a qualitative study exploring
the process of decision making and the influences of obesity stigma. Methods:
A pragmatic qualitative methodology, conducting indepth interviews with 52
participants all with BMI > 30 kg/m2 and experience of efforts at
weight management. Equal numbers of men and women with mean age 56.9 years
completed interviews. Inductive analyses
proceeded through systematic steps over a series of iterations. Findings:
Decision making is difficult in the context of
on-going mixed feelings over a long time. Thoughts and feelings become ingrained with habits and it is
hard to separate out what is needed to think
through a good decision. Thinking about weight brings a large volume of
thoughts and feelings and apparent options or action choices. The volume of
thoughts makes decisions difficult but, in the context of obesity stigma,
many of the thoughts are negative. A variable sensitivity to these stigma-related
thoughts adds further ambivalence and inhibition for taking deciions. The
need for further thinking does not stand out in the context of the emotional resolving of thoughts about personal responsibility arising from obesity stigma.
Conclusions: Obesity stigma contributes to a deeper ambivalence in the decision
process and hence difficulty in decision making about weight management. Decision
aid interventions and training of health care staff in communication skills for
shared decision making are needed.
Cite this paper
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