Reimagining primary care visits for people living with obesity: A Co-design and validation study

Patients living with obesity may delay primary care visits due to negative experiences, yet their optimal primary care experience has not been defined. Our objective was to describe an ideal primary care visit in collaboration with people living with obesity and determine its validity among a sample of adults with obesity.

We employed a co-design process where participants created an ideal primary care visit scenario that was followed by a 2024 cross-sectional survey of people with obesity for validation. We recruited U.S. adults with obesity who had a primary care visit within 5 years. Participants viewed the ideal scenario and rated its overall quality on a 10-point scale [poor (1) to excellent (10)], which we compared to overall quality reported for their last primary care visit using an unpaired t-test. Participants rated the importance of 13 scenario elements on a 4-point scale ('not at all important' to 'very important').

Among the 250 survey participants, 60 % were aged 46-65 years; 90 % were women; 78 % identified as white. Mean BMI was 36.3 kg/m² (SD 10.3). Mean quality for the ideal primary care visit (9.4 (SD 1.4)) was significantly higher than their last visit (8.0 (SD 2.1)) (p < 0.01). Highly important elements were 'doctor treats me with care and respect' (96 %), 'doctor really listens' (95 %), and 'doctor refers to specialists who treat me with care and respect' (92 %).

People living with obesity prefer a primary care visit characterized by respectful treatment and listening. Primary care practices and clinicians should consider incorporating elements from this scenario in their practices.

Our findings underscore the importance of clinician education related to weight stigma and creating an inclusive environment for all patients.