The Lived Experience of Children and Adults with Overweight or Obesity Engaging in Weight Management Treatments: An Umbrella Scoping Review with Narrative Synthesis.

INTRODUCTION: Understanding the lived experience of people with overweight or obesity is essential to ensure that interventions are free from weight stigma, avoid adverse consequences including eating disorder pathology, increase engagement, and promote culturally sensitive approaches to care. We aimed to synthesize published review evidence of the lived experience of people living with overweight and obesity engaging in weight management interventions. METHODS: Database searches using defined inclusion criteria were undertaken in Ovid MEDLINE, APA PsycINFO via EBSCOHost, CINAHL Complete via EBSCOHost, and Cochrane Library. After screening and data extraction, thematic synthesis was undertaken using the Copilot large language model and verified by a researcher who had detailed knowledge of all included reviews. RESULTS: The database searches identified 4183 studies, with 38 reviews meeting the inclusion criteria. Supportive networks (including familial, social, healthcare, and employment) were key to initiation, engagement and maintenance of weight loss across all age groups and interventions. Intervention design and delivery approaches that were accessible, individually tailored, collaborative, age-appropriate, culturally sensitive, and free from judgment and stigma were key to sustained engagement with programs. CONCLUSIONS: This umbrella review identified emotional, healthcare, cultural, and societal implications for the weight stigma and bias described by participants in the current literature. By actively working to reduce weight bias and stigma in clinical practice, research, and guideline development, healthcare professionals, and academics can foster more equitable and effective weight management interventions that prioritize the long-term health of people living with overweight or obesity.