An identification and critical analysis of barriers to raising the topic of weight in general practice

Student thesis: Doctoral ThesisPhD


In light of the increasing prevalence of obesity in the UK, health professionals working within general practice are urged to initiate discussion about weight with overweight and obese patients. Despite such appeals, evidence suggests that only a minority of health professionals routinely talk to patients about weight loss. To understand more about the barriers to raising the topic of weight in general practice, three empirical studies guided by qualitative research design were carried out. The first two studies draw on psychological theory to identify barriers to raising the topic of weight. Semi-structured interviews were conducted with 17 GPs and 17 primary care nurses. The third study conducted with 20 GPs is underpinned by discourse analysis and uses trigger film interviews to capture and critically analyse the discursive production of, and macro-discourses shaping, barriers. In study 1 and 2, three main themes summarise barriers identified from GP and primary care nurse perspectives: limited understanding about obesity care, concern about negative consequences and limited time to raise a sensitive topic. In study 3, four discursive frameworks were identified as underpinning constructions about the barriers to broaching discussion about obesity: medical-reductionist, medical-holistic, moral and ethical. Findings extend understanding about the ways in which obesity is constructed as both a medical and non-medical issue. The findings have implications for health professional education, policy and research including the need to expose and challenge dominant understandings of obesity as a behavioural problem, to address barriers operating at the socio-cultural as well as the individual-level, and to enhance understanding about the socially embedded and pernicious effects of obesity stigma in the consultation and beyond.
Date of Award27 Apr 2016
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorChris Eccleston (Supervisor), Afroditi Stathi (Supervisor) & Edmund Keogh (Supervisor)


  • obesity discourse
  • Qualitative Research
  • general practitioners

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