Real-world experiences with obesity medication in the Netherlands: A mixed methods study among patients and professionals

Abstract

Background Insight into how obesity medication (OM) is prescribed, accessed, and experienced in daily practice remains limited. This study explored prescribing practices, patient experiences and perceived barriers and facilitators regarding OM use in the Netherlands. Methods This was an exploratory sequential mixed-methods study consisting of qualitative interviews followed by a cross-sectional questionnaire survey. Semi-structured interviews were performed with healthcare professionals and individuals using or considering OM (n = 14). Findings informed the development of a questionnaire completed by healthcare professionals (n = 102) and individuals using OM (n = 96). Results The qualitative analysis generated five themes: (1) navigating access and reimbursement pathways, (2) negotiating professional roles and expertise, (3) balancing medication and lifestyle support, (4) living with OM: relief, stigma and legitimacy, and (5) uncertainty and future perspectives. Quantitative findings largely supported these themes. Overall, OM care was experienced as supportive and accessible. However, important challenges were identified, including: strict reimbursement criteria, a mandatory combined lifestyle intervention perceived as insufficiently tailored to individual needs, high out-of-pocket costs, uncertainty regarding tapering strategies, and differences between regular and private care pathways. Conclusion OM is generally experienced positively within Dutch obesity care, but structural barriers remain. Improving access, reimbursement policies, professional education, and guidance regarding long-term treatment and tapering may contribute to more equitable and sustainable obesity care.