The Views of Adult Weight Management Dietitians on Service Provision for People With Obesity and Severe Mental Illness and/or Learning Disability: A Qualitative Study.

Specialist adult weight management (AWM) services (tier 3) provide multidisciplinary support for people with obesity to manage their weight. Many people with severe mental illness (SMI)/learning disability also have obesity. This study explored the opinions of specialist AWM dietitians in the North-East and North Cumbria (NENC) region regarding their skills, knowledge, and services for supporting people with obesity and SMI/learning disability. Dietitians (n = 9) were purposively selected and interviewed using Microsoft Teams in July 2023. The data was thematically analysed. Dietetic pre-registration training on SMI/learning disability was inconsistent. Dietitians' confidence in supporting people with SMI/learning disability was wide-ranging. Six themes were identified: training, resources, service provision, networking & external influences, assessment and compassion & self-efficacy. Specialist AWM dietitians in the NENC region are compassionate and want to provide a quality service for people with obesity and SMI/learning disability. However, they sometimes feel they fail these service users through a lack of training and resources. Training, accessible resources, and collaboration with mental health dietitians may improve AWM dietitians' confidence and skills when supporting people with SMI/learning disability and may reduce stigma. The British Dietetic Association (BDA) may wish to ensure training on SMI and learning disability is available for all dietitians, along with resource sharing. Additionally, limited staffing and waiting lists may impact the provision of reasonable adjustments required for people with additional needs. Alternative pathways for people with obesity and additional requirements may be of benefit. More comprehensively completed referrals and additional funding may facilitate this.