A qualitative study to examine hidden care burden for older adults with overweight and obesity in England

Objectives: The study aimed to explore the phenomena related to formal and informal social care needs among overweight and obese older adults living in England. Background: Despite the rising prevalence of obesity among older adults, its impact on social care needs remains underexplored. Existing research highlights significant unmet social care needs among older adults, yet the specific challenges faced by those who are overweight or obese have received limited attention. This study addresses this gap by exploring and understanding the social care experiences and needs of older adults in England who are overweight or obese. Methods: Participants were recruited from a local National Health Service (NHS) health centre in London England using a purposive sampling strategy to the point of analytical saturation. A total of 45 participants were invited and of these 33 participants were eligible to take part. All participants in this study are either of British origin or immigrants to the UK from various nationalities. A semi-structured interview was conducted, and a qualitative structural narrative analysis was undertaken. Results: The study found that older adults, who are overweight or obese, were more likely to have physical health problems and problems with mobility. They were more likely to have informal voluntary care and support rather than formal social care support. They also had a weaker social support network, were more isolated and frustrated, lacked housing adaptations, felt unsafe, felt they were a burden to their families and felt discriminated against by the wider community. Care and support needs if not met, then these are likely to generate or widen health inequalities over time. Conclusions: This study provides a unique perspective on unmet care needs among overweight and obese older adults in England. It highlights the compounded challenges faced by this population, emphasising the importance of holistic social care approaches that address both health and psychosocial needs. Findings suggest that minimal yet targeted interventions, such as accessible support networks and public health policies promoting social engagement, could significantly improve wellbeing and reduce long-term health inequalities.