Poster Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

Social isolation and loneliness in people with clinically severe obesity: a qualitative study of the perspectives of patients and clinicians (129164)

Ghada Alsultany 1 , Milan Piya 1 2 3 , Kathryn Williams 4 5 , Kate A McBride 1 2
  1. Translational Health Research Institute (THRI), Western Sydney University, Campbelltown, NSW, Australia
  2. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
  3. South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden and Campbelltown Hospitals, Campbelltown, NSW, Australia
  4. Charles Perkins Centre , The University of Sydney, Kingswood, NSW, Australia
  5. Family Metabolic Health Service, Dept of Endocrinology, Nepean Hospital, NBMLHD, Kingswood, NSW, Australia

Background People with clinically severe obesity may experience greater social isolation and loneliness (SIL) leading to poorer health outcomes and reduced treatment engagement. The experience of living with SIL in this population and its clinical consequences remain poorly characterised. As such, understanding and addressing SIL in this population has become increasingly important. Exploring this further is critical to improving treatment engagement and outcomes.

Methods: Qualitative study one‑to‑one semi‑structured interviews with adults living with clinically severe, recruited through targeted and snowball sampling from tertiary metabolic clinics in Sydney and the Weight Issues Network. Concurrently, focus groups with clinicians from the same tertiary clinics were conducted to gain their perspectives on SIL among patients living with obesity in their care. Discussions explored participants’ social networks, experiences and drivers of SIL, impacts on mental health and treatment engagement, and potential support strategies. All sessions were audio‑recorded, transcribed, and analysed thematically using Quirkos.

Results: n=13 patients and n=14 clinicians across 2 focus groups. Our data shows that SIL is driven by internal (shame, stigma, low self-esteem), external (accessibility, built environment, cost), and social (bullying, judgement) barriers to connection. Additionally, difficulty in addressing SIL stem from a bidirectional relationship with mental health, inconsistent assessment of SIL in clinical practice, and inadequacies of existing support structures. Both patients and clinicians highlighted the need for group‑based, in‑person activities and peer support but stressed the need for flexible and accessible delivery.

Conclusions: These findings highlight that SIL in clinically severe obesity is driven by complex factors with current supports being neither sufficiently tailored nor sustainable. To overcome these barriers interventions should offer safe, non‑judgmental environments; integrate therapeutic, social, and physical activities; and ensure ongoing, meaningful contact - ideally co‑designed with patients and clinicians to address barriers and reach those most at risk.