With the increasing prominence of overweight and obesity among Chinese residents, 16 departments, including the National Health Commission of the People's Republic of China, jointly launched the "Healthy Weight Management Year" plan. Weight management services in Community Health Centers (CHC) in China are currently in the initial exploratory stage, and a systematic analysis of their specific implementation is lacking.

To investigate the service models of weight management clinics in CHC in Shanghai, identify the implementation barriers during the service process, and explore feasible optimization strategies, aiming to provide a reference for the normalized and high-quality development of weight management services in CHC.

From September 10 to December 23, 2025, purposive sampling combined with snowball sampling was employed to recruit participants. Two administrators responsible for weight management affairs in Shanghai municipal health authorities were invited to participate. Additionally, one CHC was selected from each of the 12 districts in Shanghai, and the director of the weight management clinic or frontline healthcare workers at each CHC were invited to participate in semi-structured interviews. The interview guide was developed through a systematic review of relevant literature and policy documents, supplemented by a preliminary investigation. Thematic framework analysis was applied to organize and analyze the interview data.

A total of 14 interviewees were included in this study. Through thematic analysis of the interview data, four themes were identified. (1) CHCs in different administrative areas developed differentiated service models tailored to local conditions; (2) Medical personnel face challenges including high workloads, limited professional resources, and a low sense of professional identity within weight management services; (3) The motivation to engage in weight management is shaped by external factors, such as professional identity and incentive structures; (4) From the standpoint of medical institutions, residents' personal perceptions and beliefs regarding weight management significantly influence their willingness and behavior towards self-management.

The majority of CHC in Shanghai have successfully integrated and specialized their weight management services. Nonetheless, numerous challenges persist in delivering standardized and sustainable weight management services. These challenges include the escalating demand for services, the absence of a comprehensive training system, ambiguous management objectives, inadequate incentive mechanisms, and the necessity to elevate residents' awareness. Consequently, there remains a need for improvement in CHC weight management services, particularly concerning institutional support, personnel training, resource allocation, and the provision of detailed weight management guidance to residents.