Abstract
<title>Abstract</title> <p>Background Obesity is a growing public health concern and a major contributor to non-communicable diseases, particularly in low- and middle-income countries like Pakistan. Despite the availability of evidence-based interventions, many programs fail to consider the cultural and contextual realities of local communities, limiting their effectiveness. Objective This study aimed to develop a culturally appropriate, evidence-based strategy for body weight management and obesity prevention in a rural community in Pakistan. Methods An explanatory sequential mixed-methods design was used. The first phase involved a systematic review and meta-analysis to identify effective interventions for obesity prevention. The second phase explored community perceptions and practices related to body weight management through a qualitative descriptive approach. Findings from both phases were integrated using a joint display to generate meta-inferences, which informed the development of a contextualized program based on the WHO (2012) planning model. Results The quantitative findings showed that interventions combining education and counselling significantly reduced body mass index and waist circumference, particularly when implemented for longer durations (≥ 6 months). The qualitative findings highlighted the importance of awareness, cultural beliefs, lifestyle practices, and strong family and community support systems in shaping health behaviors. The integration of both phases emphasized that effective weight management requires not only evidence-based strategies but also alignment with local culture and community structures. Based on these findings, a comprehensive program incorporating assessment, awareness, education, and counselling (AACE) was developed. Conclusion The study demonstrates that combining scientific evidence with cultural context can lead to more effective and sustainable obesity prevention strategies. The developed program provides a practical framework for community-based interventions and has the potential to be adapted and implemented in similar settings to improve public health outcomes.</p>