Overweight and obesity: helping clients to take action.

This article presents the results of a qualitative research project to explore factors that encourage or discourage overweight people from low income groups to access weight loss services. Semi-structured interviews were conducted with 16 people attending a commercial slimming organization in South Yorkshire. The study revealed weight loss decisions to be complex and fragile. The experiences reported mirror the 'stages of change' model described by Prochaska and DiClemente (1992). Triggers to action occurred cumulatively and decisions were reached gradually. The triggers included embarrassment and humiliation, health, fear, critical events and image. Disincentives to action were denial, previous bad experiences, previous failure and money. Decisions were linked to low self-esteem and confidence, making people vulnerable at the point they take action. The implications of this for nursing practice and services in primary care are considered.