Background : Quantitative studies have shown that people living with obesity experienced deteriorations in mental health and health-related behaviours during the first UK’s Coronavirus Disease-2019 (COVID-19) lockdown. However, there is a lack of qualitative research exploring their lived experiences during this period.

Methods : Thematic analysis of large-scale free-text survey data was conducted to understand the challenges faced by adults with obesity during the first UK’s COVID-19 lockdown.

Results : Among 543 participants, 467 (86%) responded to the free text questions. The majority were female (87.8%), with a mean age of 51.6 (SD 9.9) years. Of these, 65.3% has a body mass index ≥40 kg/m ² , and 57.7% were not enroled in weight management services. Five overarching themes and 10 sub-themes were identified with the five key themes being (1) increased fear and anxiety, (2) the impact of obesity being classified as ‘high risk’, (3) disruption in weight management services, (4) the impact on health-related behaviours, and (5) the adverse impact on mental health. Participants expressed fear of contracting COVID-19 and concerns about weight gain. UK Government messages linking obesity with severe COVID-19 complications exacerbated feelings of shame and stigma. The reduced provision of weight management services caused further health concerns, highlighting the need for digital health technologies for continued support. Participants reported changes in shopping, diet, physical activity, and sleep patterns, leading to deteriorated mental health.

Conclusion : People living with obesity experienced distinct challenges during the first COVID-19 lockdown, affecting their ability to practice and maintain health-related behaviours.