‘Life changing or a failure’? Qualitative experiences of service users from the weight maintenance phase of the NHS Low Calorie Diet Programme pilot for type 2 diabetes
DOI:
https://doi.org/10.15277/bjd.2024.432Keywords:
type 2 diabetes, obesity management, Low Calorie Diet, qualitative, longitudinal, weight maintenance, Re:Mission studyAbstract
Background: The weight maintenance phase of the NHS Low CalorieaDiet (LCD) programme focuses on embedding long- term dietary and physical activity changes. Understanding individual experiences of this phase is crucial to exploring long- term effectiveness and equity of the intervention approach.
Methods: This was a coproduced qualitative study underpinned by a realist informed approach, using interviews and photovoice techniques. Service users (n=25) of the NHS LCD programme were recruited from three delivery models, across 21 sites in England. Data were analysed using a thematic approach.
Results: The experiences reported were largely positive, with many participants reporting changes in their diet and physical activity. Some service users expressed a need for additional support and there appeared variation in their experiences of the service providers and the wider available support network. Fear of weight regain and its glycaemic consequences was expressed by many; various mitigations were employed, including participating in other weight loss services and continuing use of Total Diet Replacement products.
Conclusions: The NHS LCD programme has been life-changing for some people. However, service user insights suggest that a stronger person-centred focus might further improve effectiveness and service user experience.
References
Homer C, Kinsella K, Drew KJ, et al. A fresh start with high hopes: A qualitative evaluation of experiences of the Total Diet Replacement phase of the NHS Low Calorie Diet Programme pilot. Br J Diabetes 2024;24:ONLINE AHEAD OF PUBLICATION. https://doi.org/10.15277/bjd.2024.435
Homer C, Kinsella K, Brown T, et al. “Trying to make healthy choices”: the challenges of the food reintroduction phase of the NHS Low Calorie Diet Programme pilot for type 2 diabetes. Br J Diabetes 2024;24:ONLINE AHEAD OF PUBLICATION. https://doi.org/10.15277/bjd.2024.436
Homer C, Kinsella K, Marwood J, et al. The Re:Mission study: Evaluating the NHS Low Calorie Diet pilot - an overview of service user data collection. Br J Diabetes 2024;24:ONLINE AHEAD OF PUBLICATION. https://doi.org/10.15277/bjd.2024.433
NHS England. NHS Low Calorie Diet Programme – face to face [one to one/group] delivery model - Service Specification. 2019.
Hall KD, Kahan S. Maintenance of lost weight and long-term management of obesity. Medical Clinics North Am 2018;102(1):183-97. https://doi.org/10.1016/j.mcna.2017.08.012
Carroll P, Mygind V, Anderson J, Khot F, Simpson J. Patient reported outcome measures in weight management service evaluation. Journal of Human Nutrition Dietetics 2011;24(4):381-2. https://doi.org/10.1111/j.1365-277x.2011.01177_9.x
Pawson R and Tilley N. Realistic evaluation.: Sage; 1997.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Inter J Qual Health Care 2007;19(6):349-57. https://doi.org/10.1093/intjhc/mzm042
Sparkes AC, Smith B. Qualitative research methods in sport, exercise and health: From process to product. Routledge, 2013.
Drew KJ, Homer C, Radley D et al. A qualitative study of the experiences of individuals who did not complete the NHS Low Calorie Diet Programme Pilot. Br J Diabetes 2024;24:ONLINE AHEAD OF PUBLICATION. https://doi.org/10.15277/bjd.2024.434
Braun V, Clarke V, Weate P. Using thematic analysis in sport and exercise research. Routledge handbook of qualitative research in sport and exercise 2016; pp191-205.
Roberts K, Cavill N, Rutter H. Standard evaluation framework for weight management interventions. National Obesity Observatory, 2009.
Jebeile H, Cardel MI, Kyle TK, Jastreboff AM. Addressing psychosocial health in the treatment and care of adolescents with obesity. Obesity (Silver Spring) 2021;29(9):1413-22. https://doi.org/10.1002/oby.23194
Radley D, Drew KJ, Homer C et al. Participant experiences during the NHS Low Calorie Diet Programme pilot. Findings from an online survey. Br J Diabetes 2024;24:ONLINE AHEAD OF PUBLICATION. https://doi.org/10.15277/bjd.2024.431
Rehackova L, Rodrigues AM, Thom G, et al. Participant experiences in the Diabetes REmission Clinical Trial (DiRECT). Diabetic Medicine 2022;39(1):e14689. https://doi.org/10.1111/dme.14689
Nagy A, McMahon A, Tapsell L, Deane F, Arenson D. Therapeutic alliance in dietetic practice for weight loss: insights from health coaching. Nutrition Dietetics 2018;75(3):250-5. https://doi.org/10.1111/1747-0080.12405
Blane DN, Macdonald S, Morrison D, O’Donnell CA. The role of primary care in adult weight management: qualitative interviews with key stakeholders in weight management services. BMC Health Serv Res 2017;17(1):1-9. https://doi.org/10.1186/s12913-017-2729-7
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