How do people living with obesity who use obesity services perceive healthcare professionals’ representation of the disease on social media? An interpretative phenomenological analysis

Objectives: The objective of this study was to explore how people living with obesity who use obesity services perceive healthcare professionals' (HCPs) online representation of the disease on social media. By exploring their perspective, we aimed to develop a framework to inform good practice around social media use for HCPs. Design: This was a qualitative study using a phenomenological framework. Following in-depth semi-structured interviews, analysis was undertaken to identify superordinate themes relating to how HCPs portray living with obesity online. Setting: Patient advocacy organisation (The Irish Coalition for People Living with Obesity) and three clinical sites offering obesity treatment in Ireland. Participants: 15 adult participants comprising of 12 women and 3 men who use social media and are living with obesity and who use obesity services. Results: Three key themes of how people living with obesity who use obesity services perceive HCP's online representation of the disease. (1) Negative experiences of HCPs-participants describe encountering weight stigma and bias on social media from HCPs that they characterised as simplistic and outdated conceptualisations. These engender shame, fear and anger. (2) Positive experience of HCPs-participants report social media allows HCPs to educate and inform public perception of obesity. Positive online experiences lead to feelings of inclusion, understanding and encouragement. (3) Expectations of HCPs-qualifications, professional titles and academic association affected the perceived trustworthiness of information and its impact on readers. Participants feel there is a duty of care for HCPs in obesity medicine to advocate and be active online to provide accurate medical information. Conclusion: HCP's use of social media has a powerful impact on people with obesity who use healthcare and obesity services. Social media is a key tool in obesity awareness and education. We propose the '3E' framework-Empower, Evidence-Based and Educate and be educated to guide HCPs' social media use.