Barriers and Facilitators to Engagement With a Weight Management Intervention in Asian Patients With Overweight or Obesity: A Systematic Review

The obesity epidemic is a global health concern with Asian countries facing one of the most rapid rises in obesity rates. However, given the underwhelming long-term efficacy of weight loss strategies, especially in Asia, this review aims to explore barriers and facilitators to weight management of patients with overweight and obesity in Asia.Medline, CINAHL, PsycINFO and Web of Science were searched for articles discussing barriers and facilitators of treatment to obesity from both healthcare professionals (HCPs) and patients. Qualitative and mixed method studies from Asia were included. Key quotes were extracted, coded, and thematically analysed with reference to Thomas and Harden's methodology.A total of 26 articles were included in this review. From the patients' perspective, three main themes were identified, factors influencing poor eating behaviour, inhibiting lifestyle modifications, and facilitating lifestyle modifications. Patients highlighted several barriers including the lack of social support, physiological limitations to exercise and low health literacy. Rigid sociocultural norms and lack of accessible healthcare services, exercise facilities and healthy food exacerbated the barriers. Facilitators to lifestyle modifications consisted of strong support systems and high health literacy. HCPs agreed that low health literacy, lack of social support and patient motivation impeded patients' weight loss attempts but were unaware of the other barriers they faced.There are discrepancies between ideas of barriers and facilitators of HCPs and patients. A mixture of population-level, primary care, and personal interventions are required to address this disparity and enhanced health literacy would improve weight loss outcomes.