The real-life experiences of people living with overweight and obesity: A psychosocial perspective.

Understanding the lived experience of obesity, just like any other chronic outcome, is essential to addressing deep routed inequalities and stigma associated with obesity, as well as creating more inclusive and effective policies and healthcare. The psychosocial aspects of obesity are vast and as such the lived experience of obesity differs between individuals and groups. However, there are consistent psychosocial issues identified within empirical studies as well as lived experience accounts that require consideration and potential adaption in the design and delivery of care including weight management and obesity services. Improving perceptions and understanding of the lived experience can also foster empathy which appears to be lacking based on research examining everyday encounters, media portrayal of people living with obesity, and in healthcare settings. Stigma and discrimination are consistent and, in some instances, occur daily in many societal settings leading to mental and physical health concerns, social disengagement and dysfunctional relationships with significant others, as well as avoidance of health promoting activities and settings. Using a narrative review approach, our aim was to examine the empirical evidence generated in countries across the world, reporting on the real-life experiences of people living with obesity. Our search strategy was informed by existing empirical evidence of the psychosocial aspects of obesity and an in-depth interview exploring the lived experience of obesity specifically conducted to inform this article. In doing so, we highlight key psychosocial aspects and provide a voice for a personal account of the challenges experienced in child and adulthood. Recommendations are offered for stakeholders including policymakers and practitioners that aim to address these real-life challenges experienced by people living with obesity. PLAIN LANGUAGE SUMMARY: In this publication, the authors provide a detailed review of the lived experiences of people living with obesity with a focus on the psychological and social factors and experiences across the life course. The paper also uniquely presents real-life experiences from Sarah, who identifies as living with obesity. In doing so, the authors highlight exposure to and experiences of weight management related behaviours and weight stigma from an early age. Experiences of weight stigma and feelings of being excluded from social settings and more generally society are evidenced throughout. Indeed, Sarah's accounts support the research evidence presented, where for instance, she highlights feeling excluded as a younger person when not being able to purchase "trendy" clothing and as an adult when buying clothing for work, experiences of weight stigma in workplaces and issues related to travelling as well as the actions she takes to avoid imposing on other people. The key lived experiences, both from the research evidence and Sarah's accounts, provide insights about the link between obesity and mental health, where for instance, the experiences of weight stigma and feeling excluded from society are associated with mental health outcomes including reduced self-worth and self-esteem, increased depression and increased risk of self-harming. The authors provide a list of ways to address weight stigma in society as well as in healthcare, a setting where weight stigma is often reported by people living with obesity, and calls for greater involvement of people living with obesity in policy, healthcare development and practice, as well as the need to address the widespread weight stigma and discrimination. [Plain language summary added March 2025, after original online publication].