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EBHC DPhil student, Nicole Juul-Hindsgaul, is investigating what success looks like in obesity management. In this blog, Nicole explains how qualitative research methods can be used to better understand how success is defined and the experiences of those living with obesity.

Young student girl working, learning in college library © Shutterstock

Obesity is a chronic and complex disease that impacts millions of people worldwide. To best fit the needs of the people living with obesity, treatment or management should reflect the complexity of the disease.

Quantitative research methods are great for confirming your theory or hypothesis. One such quantitative method is a randomised controlled trial. These types of trials can investigate if one intervention is better at providing weight loss than another. Currently, obesity management is built on the assumption that one must lose weight to be successful. However, confirming if one intervention is better than another at providing weight loss doesn’t necessarily prove if weight loss is the right outcome to be measured against.

My DPhil work has highlighted that understanding what success looks like is complex and unclear in terms of obesity management. Moreover, it seems that current criteria of success don’t account for the valuable perspectives and experiences of those living with obesity.

My DPhil research is about understanding success in obesity management and how success is defined and by whom. I’m interested in learning how national health services or health guidelines define success, how doctors define success, and how people living with obesity define success. To do this, the DPhil will involve some qualitative research. This research approach is most useful when answering questions that start with “How?”. Qualitative methods allow the researcher to investigate concepts and provide a description or understanding of a situation.  

For the first stage of research, I looked at how clinical guidelines defined success. I used an approach called framework synthesis to do so. I systematically searched for all relevant clinical guidelines. I then extracted and organized the data against a framework. This organization helped me compare and contrast data from the guidelines in order to develop and construct themes of success.

For the next stage of my research, I’m interested in speaking directly with people living with obesity and asking them about success. I’ll also interview clinicians who provide obesity management to people living with obesity. To inform the questions I ask during these interviews, I will start by conducting a thematic synthesis to address the question “What does success look like to people living with obesity in obesity management treatment?  A thematic synthesis is a systematic review of qualitative research. By conducting this synthesis, I will be able to gather qualitative data already available and identify and develop themes explaining people’s perspectives of success.

This type of research is a first for me. So, beyond reading and asking my supervisors, I have attended courses to learn more about qualitative research methods. Once I had identified that conducting a systematic review would be most appropriate, I attended an introduction to qualitative systematic reviews workshop. It covered stages involved in conducting this type of review and different approaches to synthesizing qualitative papers.

Attending the course helped me feel that I was going in the correct direction with my research. I learned more about the different methods, learned from previous examples, and most importantly, had the opportunity to ask questions. I am now much more confident that the approach I intend to use is the most appropriate to answer my research question.

I hope to provide a new understanding of and improved vocabulary for describing success in obesity management. Once we understand success better, our research and management of obesity can also reflect the complexity of the disease and be better suited to people living with obesity. The findings will be helpful for healthcare providers, policymakers, and guideline developers.