From Silence to Support: What Patients Tell Us About Seeking Obesity Care 

From Silence to Support: What Patients Tell Us About Seeking Obesity Care 

Bariatric surgeryWritten by Ingrid Kruizinga

Medical Affairs Specialist

Despite advances in obesity treatment, many people living with obesity experience long and frustrating delays before they reach appropriate care. A new qualitative study by Schreurs and colleagues (2025) gives voice to those patients, exploring their help-seeking journey and the barriers that prolong it. 

Recognizing Obesity and Acting Alone

For many, the onset of obesity started early. One participant recalled: “Yes, in elementary school. You’re fatter than all the other little kids and much fatter” (patient 2). Others linked their weight gain to life events such as pregnancy, divorce, or quitting smoking. 

Before seeking medical care, most tried to manage on their own. This often meant diets, exercise, herbal remedies, or even hypnosis. As one participant shared: “Trying it myself and then all the commercials you see of pills and drops to lose weight, you try but…” (patient 7). When these efforts failed, patients often disengaged from the healthcare system, reinforcing the belief that it was their personal responsibility to “try harder.” 

Triggers for Seeking Care 

Four main factors eventually pushed patients toward professional help:

  • Health complications such as type 2 diabetes, cardiovascular disease, or sleep apnea were major turning points. One patient described: “So I had sleep apnea… from there they came to the conclusion, my heart sometimes stops. And then I ended up in the diabetes clinic where they told me I qualify for a gastric ring or for a bypass” (patient 6).
  • Referrals by others, including family, friends, schools, or specialists, often initiated the first step. “Yes from my parents’ point of view then, it was about three or four years… you have to do something about your weight” (patient 3).
  • Financial strain, with one participant noting the cost of special diets as decisive: “As long as you’re in that pattern and you’re spending a lot of money to eat those products and you’re not constantly starving, then you’re fine” (patient 3).
  • Internal motivation, often linked to fertility, marriage, or retirement. As one patient said: “It’s because I had my desire for children that I actually did that stomach reduction” (patient 5). 

Why Care Is Delayed 

Three main barriers prolonged treatment delay: 

  • Inefficient referral – Patients described seeing multiple dietitians without being connected to a multidisciplinary team. “I saw a lot of different dietitians. In Antwerp, I saw 3–4. Here in Brussels I saw 3–4” (patient 12). Some GPs even discouraged referrals, perceiving dietitians as commercially driven. 
  • Pressure from society – Many internalized the stigma of being told to simply work harder. “Because I’ve been told a lot from those around me, just do a little bit more exercise, just put in a little more effort. Oh okey, maybe I haven’t tried hard enough after all…” (patient 13). This delayed acceptance that professional care was necessary. 
  • Barriers to surgery – Fear of irreversibility was common: “That scares me a little bit… The problem is, you can’t go back” (patient 14). Legal age restrictions also delayed access: “Back then I was 17, so that was impossible to do surgery when you’re a minor” (patient 12). 

Interestingly, patients generally did not perceive waiting times for appointments or surgery as a major obstacle. Instead, some valued the preparation: “It’s something that is going to change your life. It’s best to do that considered for a while and not quick quick…” (patient 10). 

Practical Key Takeaways

  • Recognize early: Many patients trace obesity back to childhood. Address it proactively. 
  • Refer efficiently: Move beyond diet-only advice; connect patients to multidisciplinary teams or specialized obesity centers. 
  • Address stigma: Challenge the “just try harder” narrative. Reinforce that obesity is a chronic disease. 
  • Look beyond complications: Don’t wait for diabetes or cardiovascular events to start treatment conversations. 
  • Support informed decisions: Provide clear, balanced information on pharmacotherapy and surgery to reduce fear and delay. 

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Source:

  1. Schreurs, L., De Smedt, C., Goris, E., Unuane, D., Schoneveld, M., Steenackers, N., … & De Cock, D. (2025). “Just put in a little more effort”: the help-seeking experience of patients living with obesity: Behavior, Psychology and Sociology. International Journal of Obesity, 1-8.

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