Abdullah Kaan Kurt, Ersan Gürsoy
Among adults with accurate body-size perception, obesity was experienced as an embodied and socially situated burden, with change efforts characterised by fatigue and recurring cycles. Interventions may benefit from stigma-sensitive, person-centred care that addresses functional limitations, emotional drivers of eating, and longer-term behavioural support.
BACKGROUND: Obesity is commonly framed through biomedical risk, yet it is also lived through functional limitations, emotional burden, and socially mediated experiences. Body-size perception may shape how individuals appraise risk and engage with change, but qualitative work has seldom focused specifically on adults who accurately perceive their body size.
AIM: This study explored how adults attending an obesity outpatient clinic with accurate body-size perception conceptualise obesity and describe its implications for everyday life and change efforts.
METHODS: An interpretivist qualitative design was used. Participants were recruited from the Obesity Outpatient Clinic of Karadeniz Technical University Farabi Hospital using criterion-based purposive sampling with volunteer recruitment (May-August 2025). Accurate body-size perception was defined as concordance between measured BMI and the BMI range of the silhouette selected from BMI-anchored body-size guides. Semi-structured, one-to-one interviews (20-30 min) were audio-recorded, transcribed verbatim, and analysed using Braun and Clarke's thematic analysis with NVivo support; reporting followed COREQ.
RESULTS: Twenty-three participants were interviewed (mean age 46.1±10.1 years; mean BMI 35.5±4.6 kg/m²). Four overarching themes were generated: (1) health, functioning, and everyday life; (2) body image and emotional experience; (3) explanatory models and perceived causes of obesity; and (4) the struggle for change and seeking solutions. Across themes, obesity was described as a pervasive "burden" constraining daily activities and roles, emotionally taxing through body-image distress and socially "read" weight, understood through multifactorial causal narratives (lifestyle, stress, biology/medication, household routines, and the food environment), and managed through repeated cycles of attempts, plateaus, and regain alongside a strong desire for sustained professional support.
CONCLUSION: Among adults with accurate body-size perception, obesity was experienced as an embodied and socially situated burden, with change efforts characterised by fatigue and recurring cycles. Interventions may benefit from stigma-sensitive, person-centred care that addresses functional limitations, emotional drivers of eating, and longer-term behavioural support.