Table 1.

Focus group topic guide

Topic guide for patients	Topic guide for healthcare professionals
Thoughts and experiences of weight management before and after breast cancer diagnosis: What, if any, has been your experience of weight loss before/after to your cancer diagnosis? What diets did you try? Did they work for you? If so why, and if not, why not? What have been the main challenges of managing weight since your treatment? Are you experiencing any symptoms related to your treatment? If so, what are these? Do these symptoms have an effect on your motivation to lose weight, or have they had an effect on any attempts you have made to lose weight?	Perceptions of weight gain amongst patients during treatment: What proportion of your patients with hormone-positive breast cancer are overweight/obese at point of diagnosis? What happens to women's weight status during treatment and post-treatment? In your opinion do hormonal therapies or medications have any impact on a patient’s weight/attempts to lose weight/maintain weight loss? In your opinion do chemotherapy have any impact on a patient’s weight/attempts to lose weight/maintain weight loss?
Understanding dietary behaviours: What do you think about diets? Have you tried dieting since your treatment? Did your clinical team encourage/endorse diet modification for helping with weight management following treatment? Do those in your social circle (family and friends) support you when trying to manage your weight? How can we help women who are living with and beyond cancer to make changes to their diet that could help with weight management / loss?	Current practice: Do you have conversations with patients around healthy eating, weight management and exercise? If so, who initiates these conversations – would you always initiate such conversations, or does it happen in response to patient questions? Is any advice given “general” or do you tailor the information that you give to patients? Do you recommend weight management or exercise to manage certain symptoms associated with cancer or its treatment? Can you refer patients to community-based weight management or exercise programmes?
Understanding exercise or physical activity behaviours: Do you currently engage in physical activity or exercise? Did your clinical team encourage you to be physically active / endorse or advise exercise or physical activity for helping with rehabilitation or recovery? Did/Do you have apprehensions about being physically active or exercising? Do those in your social circle (family and friends) support you when trying to be active? What are the important questions you need answering if you are thinking about becoming physically active or exercising?	Weight management advice/information requested by patients: Are you asked by patients for specific advice on being physically active or exercising pre-treatment/ during or post-treatment? What type of information do patients ask for? Do patients ask about the risk of being overweight or physically inactive relative to disease recurrence? Do any Public Health Guidelines or cancer specific lifestyle guidelines ever feature in conversations/consultations?
Technology and weight management: Do you use technology in your daily life, e.g. websites, smartphone apps etc.? Have you ever used any technologies to help you manage your weight, follow a diet or to motivate you to be more physical activity such as on-line programmes, smartphone apps, wearable devices?	Perceived benefits of weight management advice for patients: Have you seen any benefits in patients from becoming or already being physically active/being an ideal body weight/BMI during or after treatment? If so, what are those benefits? Why do you think some patients are more successful than others in managing their weight and activity levels?
	How the provision of weight management advice could be improved: How prominent is lifestyle modification such as healthy eating and exercise a feature of clinical care/survivorship care? Do you feel confident about giving advice on healthy eating and exercise? What would help you increase your confidence to give advice? What would support your own practice? What limits your ability to deliver advice about weight management and exercise? What are the barriers to initiating or holding a conversation on these topics? What is needed to enable more health professionals to have more frequent (routine) conversations about healthy eating and exercise with their patients?