O5-02 HOW AND WHY PRECONCEPTION HEALTH AMONG PEOPLE LIVING WITH OBESITY COULD BE IMPROVED BY INCLUDING OBESITY AS A HEALTH CONDITION in: Abstracts from the 10th meeting of the Association for the Study of Obesity: UK Congress on Obesity 2025

University Of Plymouth, Plymouth, UK
People living with obesity have a greater chance of developing
complications during pregnancy and are over-represented in
maternal mortality data relating to both direct and indirect causes
during pregnancy and up to a year after the birth of their child. In
addition, epigenetic influences result in metabolic changes in
offspring of people living with obesity leading to a greater chance
of them experiencing long-term health consequences. In view of
these health concerns, people living with obesity are advised to lose
weight in the preconception period, before becoming pregnant.
Sustained weight loss, however, can be difficult to achieve, and
people do not always seek preconception advice. The aim of this
study was to explore what form of preconception care for people
with health conditions, including those living with obesity, works, for
whom, how, and in what circumstances. Realist methodology was
used to identify causal explanations, involving consideration of
unobservable processes or powers. A realist evaluation involved 31
qualitative interviews with relevant stakeholders: women living with
health conditions (n = 20), including those living with obesity (n = 3),
their partners or supporting family members (n = 2), and healthcare
professionals involved in providing preconception care (n = 9). The
multi-stage realist evaluation generated 13 refined middle-range
theories, providing causal explanations of what works for whom, and
how. Of these, one specifically relates to achieving support to
improve preconception health for people living with obesity. The
mechanisms identified involve resources that include monitoring and
treatment, and reasoning that reduces feelings of guilt or blame,
facilitating effective communication between the person living with
obesity and their healthcare professional. This is the first study of
preconception care for people with health conditions, including
people living with obesity, using a realist approach. The findings
identified obesity as an outlier, when compared with health
conditions such as diabetes or epilepsy, which are monitored, treated, and for which preconception care is offered by healthcare
professionals. It provides a causal explanation of how preconception
health could be improved by including obesity as a health condition
and emphasises the importance of treating people with kindness
and respect.
Disclosures: None