Qualitative studies of obesity: A review of methodology

BACKGROUND: There is a developing interest in qualitative research to understand the perspectives and experiences of people living with obesity. However, obesity is a stigmatised condition associated with negative stereotypes. Social contexts emphasizing large body size as a problem, including research interviews, may amplify obesity stigma. This study reviews the methodology employed by qualitative studies in which study participants were obese and data collection involved face-to-face interviews. METHODS: Database searches identified qualitative studies meeting inclusion criteria from 1995 to 2012. Following screening and appraisal data were systematically extracted and analyzed from 31 studies. RESULTS: The studies included 1206 participants with a mean age of 44 years and mean BMI of 37 kg/m. Women (78.8%) outnumbered men (21.2%) by four to one. Socio-economic background was not consistently reported. The studies employed similar, typically pragmatic, qualitative methodologies, providing rich textual data on the experience of obesity derived from face-to-face interviews. The majority considered quality issues in data collection, analyses and generalizability of findings. However, the studies were weak as regards researcher reflexivity in relation to interviewer characteristics and obesity stigma. CONCLUSIONS: The impact of obesity stigma has not been attended to in the qualitative research. Clear information about study participants is essential, but studies involving face-to-face interviews should also report on interviewer characteristics including body size.