Leadership in Obesity Care: Strategies to Support Healthcare Professionals in Effective Decisions, Communication, and Solutions - A Scoping Review.

Obesity care is central to addressing the global prevalence of obesity, yet patients still report lack of access to effective obesity-related services. Leadership among healthcare professionals (HCPs) is enacted through clinical decision-making, service design, advocacy, and communication practices that shape patient experience and access to care. In obesity prevention and management, it is therefore critical to translate evidence into effective, equitable practice. This study conducted a scoping review, with the question: "What leadership strategies in obesity care can support healthcare practitioners with effective decisions, communication, and solutions for people living with obesity?". Data from primary studies were synthesized in accordance with scoping review best practice and PRISMA guidelines. In total, 28 primary studies published between 2014 and 2025 were included. Obesity care and support strategies were mapped inductively according to frequency of strategy approach across studies, resulting in three categories: 1. Structural strategies; 2. General strategies; 3. Population-specific strategies. Findings were then synthesized deductively from the research question under the headings of 1. Communication; 2. Decision-making; and 3. Solutions. Mapping identified that the evidence base reporting adequate strategies remains limited, with gaps across policy, research, and practice compared with other chronic conditions. Key findings highlight calls for leadership at a structural level, particularly towards improving policy to address weight stigma across domains, and ensure that services are adequately resourced and financed. At service levels, the provision of high-quality and evidence-based obesity care requires the need for leadership in the development and evaluation of multi-level, interdisciplinary, and holistic approaches. HCPs also require training with skills for constructive conversations about weight, and in collaborative healthcare planning. To improve outcomes for people living with obesity, healthcare requires coordinated leadership across systems to address the drivers of obesity and ensure equitable access to services that are evidence-based, de-stigmatized, well-resourced, and supported by policy.