Empowerment in Obesity and Behavioral Weight-Management Programmes: A Scoping Review.

Abstract

In the UK, over 25% of adults are living with obesity, with disproportionately higher rates among Black adults (35%) and those in the most deprived areas (36%). Obesity is linked to increased comorbidity, mortality, stigma, and substantial annual health costs exceeding £11.4 billion. Behavioral weight-management programmes are the primary intervention recommended for obesity treatment, yet they demonstrate limited effectiveness, inadequate long-term support, a lack of personalized care and poor cultural relevance. Participatory approaches, that is, bottom-up strategies engaging communities, are increasingly applied in public health to address social determinants and reduce disparities. Individuals supported to manage their health and access care are considered "empowered"; however, this concept remains ambiguous, lacking clear definition and consistent application. Although global policy promotes empowerment to promote individual health, including weight-management, no review has explored its role within obesity and weight-management programmes. This scoping review examined how empowerment has been defined and implemented across behavioral weight-management programmes. Eleven studies were identified published between 2004 and 2023, revealing poor consensus in their theoretical foundations, definitions, and practical applications of empowerment, with no UK-based studies. To support conceptual clarity, studies definitions and empowerment-based processes were consolidated. Further research is needed in UK settings to help define empowerment in this context and to enable effective translation between research, practice, and policy.