Psychological support within Tier 2 Adult Weight Management Services, are we doing enough for people with mental health needs? A mixed-methods survey

Background: Depression and obesity are two of the most highly prevalent global public health concerns. Obesity and poor mental health are strongly associated, and it is likely that mental health needs are common in people seeking weight management services. Aims: To identify what psychological support is provided and required in tier 2 adult weight management services (T2 WMS). Methods: Online survey: quantitative data was summarised, and open-ended free-text questions were coded and thematically analysed. Results: Participants were current or recent service users with self-reported mental health needs (n = 27), commissioners (n = 9) or providers (n = 17). Over half of service users did not feel their mental health needs were met and 60% said they would like additional psychological support within T2 WMS. Findings highlight the lack of psychological and emotional support. Psychological support and behaviour change techniques are conflated, with a lack of clear understanding or definition of what psychological support is, either between or within service users, providers, and commissioners. Conclusions: Moving towards more person-centred care, better identification and triaging of those living with mental health issues, together with improved resources and training of providers, is crucial to improve outcomes for people living with obesity and poor mental health.