Building effective patient-centred dietetic treatment for adults with obesity in primary care: from core components, perspectives and practice to co-designing a tailored treatment toolbox. An act to connect

This thesis aimed to identify key components of effective dietetic treatment of patients with obesity in primary care and translate these into a digital toolbox for personalised care. A mixed-methods approach combined routine care data, interviews, consultation observations, and an extensive toolbox co-design process, followed by a feasibility study. Data showed that patients with more consultations and a longer treatment duration were more likely to achieve at least 5% weight loss. In interviews, dietitians and patients shared the importance of strong patient–dietitian relationships, personalised support, and attention to behavioural and contextual factors. These insights informed the co-design of a digital toolbox with 243 tools, selected and designed to be personalised, clear, culturally appropriate, and support behaviour change. A feasibility study showed that usability was rated positively, but use varied between dietitians and was limited by time constraints and poor integration into routines. This thesis highlights the importance of patient-centred, tailored care and strong therapeutic relationships for effective treatment.