Patients’ experiences of prescribed anti-obesity drugs and perceptions of support from primary care: a qualitative study

Aim To explore the views and experiences of obese patients prescribed anti-obesity drugs in primary care, including their understanding of guidance about lifestyle changes. Background Pharmacotherapy treatments are increasingly used to support obesity management. Currently, two anti-obesity drugs are available on the National Health Service (NHS): Orlistat and Sibutramine. Although detailed clinical guidelines for their use are well documented, there is little research about how obese individuals experience and view these drugs in routine care. Methods Qualitative design with semi-structured interviews conducted in participants’ homes or a health centre. Participants recruited from three general practices in Sheffield with socio-economically diverse populations using purposive sampling. Interviews transcribed verbatim and analysed using the ‘framework’ approach. Findings Health concerns are the key factor for patients seeking help with weight loss. Participants are typically ambivalent about taking anti-obesity drugs and expectations vary from unreasonably sceptical to unreasonably optimistic. There appears to be high awareness of the need for lifestyle change. Those prescribed Orlistat understood how it worked, however, those on Sibutramine and Rimonabant did not. Participants’ experiences in taking anti-obesity drugs varied greatly and changed with experiences of weight loss, side effects and quality of support. Most could identify points at which the information, choice and support provided by primary care could be improved. However, most were not aware of other avenues of support. Conclusion This study has identified a number of areas for service improvement. Better understanding of patient expectations around anti-obesity drugs should help the NHS to shape services to meet needs and make the experiences of patients more positive.