Recent epidemiological projections, including Lancet reports, indicate that obesity continues to rise globally and in Europe, where nearly 60% of adults are overweight or obese. Weight-related stigma from healthcare providers has been strongly associated with degraded care experiences and negative health outcomes. Understanding the lived experience of obesity and weight loss is therefore essential to reduce clinician bias and to support patients effectively through the physical, psychological, and social transformations associated with weight-loss interventions, particularly in the era of emerging pharmacological obesity treatments.To explore patients’ lived experience before bariatric surgery and during the first postoperative year, and to identify practical recommendations directly suggested by patients to inform care in primary care settings.A longitudinal qualitative study in the Île-de-France region included 17 adults. Semi-structured interviews were conducted preoperatively in 2024 and at one-year post-operation in 2025. Interviews were audio-recorded, anonymized, and transcribed verbatim for secure analysis. Inductive thematic analysis followed Braun & Clarke’s methodology, with manual coding and double reading. Rigor was ensured using Yong’s COREQ-32 checklist. Ethics approval and GDPR compliance were obtained. To date, 16 of the 17 patients have been followed up, with the final patient expected to be included.Preoperatively, three main themes emerged: suffering related to social and medical judgment, ambivalent relationship with body and food, and mixed anticipation of surgery combining hope and anxiety. At one year postoperatively, patients reported deep improvements in self-esteem, a generally positive experience, and significant changes in social, familial, and professional interactions. A persistent need for individualized, holistic support remained.These findings highlight the limitations of purely biomedical follow-up. Patient narratives reveal how physical, psychological, and social transformations profoundly affect experiences of obesity and weight loss. They underscore the importance of empathetic, patient-centered approaches in primary care, and illustrate how clinicians’ awareness of stigma and subjective experience can shape care outcomes.The study provides practical insights directly suggested by patients. Impactful verbatims and patient-derived recommendations could help improve support for those undergoing bariatric surgery, and enrich the broader care of patients with obesity within primary care practice. Keywords: Obesity; Bariatric Surgery; Family Practice; Qualitative Research; Body Image;

The prevalence of overweight and obesity is increasing worldwide and is associated with cardiovascular morbidity, musculoskeletal complaints, depression, and reduced societal participation. In the region of XXXX, the prevalence of overweight was 57% and that of obesity 30% in 2024. These figures are strongly influenced by social determinants of health. Addressing obesity therefore requires an interprofessional approach that extends beyond healthcare into prevention, social support and education. Our aim is to develop and implement an integrated regional approach to overweight and obesity that connects primary care, social services, citizens, and interprofessional education.In the region of XXXX, a unique funding opportunity enabled the development of a one-year  program, with the prospect of continuation for three additional years. Starting March 1st, 2026, the program consists of three interconnected components in a region with over 500.000 inhabitants: a. A managed care approach initiated in all willing general practices, involving general practitioners, practice assistants, lifestyle coaches, and social workers. b. Vouchers for inhabitants to support changes in their living environment that promote a healthy lifestyle. c. Interprofessional community-based education involving students from social work, sports, nursing, physiotherapy, dietetics, and medical school.Municipalities aim to fulfil their statutory preventive tasks; social work seeks a stronger role in obesity guidance; general practitioners wish to identify and appropriately refer patients while addressing medical causes where needed. Citizens emphasize the importance of tailored, non-paternalistic approaches within their own communities. Educational institutions aim to align with regional initiatives to both meet workforce needs and contribute locally to a shift from care to health.Societal causes cannot be solved by healthcare alone. However, connecting the various stakeholders with varying goals and funding is very difficult.Preparing this program on obesity highlighted the complexity of truly understanding and integrating diverse perspectives. Nevertheless, by maintaining a shared societal goal, a comprehensive regional approach was achieved, including a key role for general practice. The first findings can be shared at WONCA2026.

This original article highlights the association between nutritional status and systemic inflammation across different BMI categories.This study aimed to determine the relationship between nutritional status and systemic inflammation using four validated nutrition indices—Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT) score, and Nutritional Risk Index (NRI)—and three immune-inflammation biomarkers—Systemic Immune-Inflammation Index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)—in healthy adults with varying body mass index (BMI) levels.This retrospective study included 290 clinically healthy adults aged 18–60 years, categorized by BMI. Individuals with chronic diseases, medication use, or morbid obesity (BMI ≥ 40 kg/m²) were excluded. Nutrition scores (HALP, PNI, NRI, CONUT) and systemic immune-inflammation indices (SII, NLR, PLR) were calculated from laboratory data. For the comparisons of SII, PLR, NLR, PNI, HALP, NRI, and CONUT values between groups, age was adjusted for, and an ANCOVA test was performed.Among the systemic immune-inflammation indices, SII and NLR were significantly higher in both the overweight and obesity groups. The CONUT score, a negative indicator of nutritional status, demonstrated positive correlations with SII, NLR, and PLR in the overweight group and with PLR in the obesity group. Although PNI showed significant inverse correlations with SII, PLR, and NLR in both groups, the mean PNI values remained above 50, indicating overall normal nutritional status in the study population. HALP was inversely correlated with SII, PLR, and NLR in both groups.Unlike many prior studies that focused on hospitalized or chronically ill patients, our inclusion of individuals without known chronic diseases allows for a clearer evaluation of subclinical inflammatory and nutritional dynamics related to adiposity. The use of a wide array of validated indices—both nutritional and inflammatory—provides a comprehensive and multidimensional assessment of immune-nutritional interactions in the context of increasing BMI.Our study demonstrates that higher BMI is associated with increased levels of systemic immune-inflammatory markers. Among the nutritional indices examined, the HALP score appears to reflect the inverse relationship between nutrition and inflammation most effectively. This index may be useful for early identification of subclinical inflammation in overweight and/or obesity populations

Weight stigma is widespread across all healthcare settings, where it has been shown to contribute to poor physical health outcomes, as well as to the persistence of obesity. Its impact in primary care setting deserves to be detailed.To synthesize evidence on weight stigma experienced or perceived by adults living with obesity in primary care, based on patient reports or data obtained from sources external to both patient and caregiver.We conducted a mixed‐methods systematic review using a convergent integrated design to combine quantitative and qualitative evidence through thematic synthesis. Five databases (PubMed, PsycInfo, Web of Science, Embase, Cairn) and grey literature were searched in 11/2025. Study selection, data extraction, and quality appraisal (MMAT 2018) were performed independently by two reviewers. Adult participants (≥18 years) with obesity (BMI ≥30 kg/m²) were included if experiences of weight stigma were investigated within primary care settings.Twenty‐five studies met the inclusion criteria (13 qualitative, 11 quantitative, 1 mixed). Weight stigma emerged at three levels: (1) in patient–provider relationships, manifested through negative assumptions, disrespectful communication, non‐verbal cues, and anticipation of judgment; (2) in obesity management, characterized by either insufficient or excessive focus on weight, oversimplified lifestyle advice, lack of referral and follow‐up, limited provider training, and communication issues; and (3) in overall care beyond obesity, with frequent attribution of any health problem to excess weight, perceived lower quality of general care, and lower screening rates for cancers. Despite widespread negative experiences, several studies also reported positive care interactions and supportive relationships.This review suggests a need to develop research on weight stigma from men’s perpective, but also from patients who are not engaged in care. It might also be interesting to study weight stigma more extensively, through direct or indirect observation of consultations or through analysis of health databases.Weight stigma in primary care affects not only weight management discussions but also overall healthcare delivery for patients living with obesity. While interventions to reduce weight stigma in clinical settings appear relevant, stigma frequently arises upstream of medical interactions and reflects broader societal attitudes. Comprehensive strategies targeting individual, educational, and structural determinants of stigma are warranted.

Weight-related stigma negatively affects the doctor–patient relationship by reducing trust, empathy, and quality of communication. Health professionals may hold implicit biases that hinder patient-centred care, yet conventional training rarely addresses this issue effectively. Participatory and arts-based methods, particularly theatre, have shown promise in engaging professionals emotionally and reflectively. However, evidence on theatre as a tool to address weight stigma in primary care remains limited.To co-design, implement, and evaluate a participatory theatre-based intervention aimed at increasing awareness of weight stigma and strengthening empathy among primary care professionals.This participatory study was conducted within a French community health network (CPTS) and comprised three stages: (1) a systematic literature review on theatre-based interventions targeting healthcare communication and the doctor–patient relationship; (2) co-construction of a play based on lived experiences shared by patients, healthcare workers, and community partners, followed by a local performance in June 2024; (3) quantitative evaluation of empathy using the Jefferson Scale of Physician Empathy (JSPE), administered to attending professionals before the performance, immediately after, and three months later. Descriptive and comparative statistics were used to analyse changes in JSPE scores over time.The literature review identified 16 studies, most reporting short-term improvements in empathy, attitudes, or communication skills following theatre interventions. The co-developed play was attended by 74 participants, including general practitioners, nurses, pharmacists, dietitians, and allied health professionals, as well as community members with lived experience. Among the 63 professionals who completed the JSPE, scores increased from 111.36 at baseline to 118.66 immediately after the play (p=0.001) and remained elevated at 116.50 three months later (p=0.015).The study drew strength from its participatory development process and from the use of a validated empathy scale. The positive shift in empathy scores indicates that theatre may facilitate emotional resonance and critical reflection among healthcare professionals. The absence of a control group is a limit.Participatory theatre is a promising, transferable approach to raising awareness of weight stigma and fostering empathy among primary care professionals. Its sustained effects at three months support its potential as a tool for continuous professional development and for improving patient-centred care in community settings.

Stress is a prevalent issue in modern society. Abdominal obesity is a key component of metabolic disease, and a major driving factor of all-cause and cardiovascular mortality. Although previous studies have linked stress with obesity or metabolic disorder, specific evidence regarding stress and abdominal obesity in recent nationally representative Korean populations remains limited.To investigate the association between the level of perceived stress and the risk of abdominal obesity among Korean adults, and to determine whether this association according to sex.This cross-sectional study included 9,525 Korean adults aged 19 years or older (4,151 males and 5,374 females) who participated in the Korea National Health and Nutrition Examination Survey conducted from 2022 to 2023. Perceived stress level was assessed via a self-administered questionnaire. Abdominal obesity was defined as waist circumference ≥90 cm in males and ≥85 cm in females, based on sex-specific cutoffs according to Korean adult criteria. Weighted multivariable logistic regression analysis adjusting for age, sex, socioeconomic factors, and health behaviors was utilized to evaluate the association between perceived stress and abdominal obesity.In a weighted multivariable logistic regression analysis adjusting for age, sex, socioeconomic factors, and health behaviors, the high-stress group had higher odds of abdominal obesity than the low-stress group (OR 1.34; 95% CI 1.20–1.50; p<0.001). The association also persisted when stratified by sex. Among males, the odds ratio was 1.35 (95% CI 1.15–1.57; p<0.001), and among females, the odds ratio was 1.37 (95% CI 1.16–1.63; p<0.001).Higher levels of perceived stress may contribute to an increased risk of abdominal obesity in Korean adults. This finding aligns with the established biological mechanisms linking stress and visceral fat accumulation by increasing cortisol secretion via the hypothalamic–pituitary–adrenal axis, as well as behavioral pathways including overeating and sedentary lifestyle.Among Korean adults, higher levels of perceived stress were associated with abdominal obesity. Similar odds ratios in males and females suggest that stress may influence abdominal fat accumulation regardless of sex. These findings highlight stress management as an important strategy for the prevention of abdominal obesity and metabolic diseases in Korean primary care.