Choosing and following a very low calorie diet program in Australia: A quasi‐mixed methods study to understand experiences, barriers, and facilitators in a self‐initiated environment

Abstract

Aim In Australian adults, this study seeks to describe the experiences and factors associated with the perceived outcomes of using a very low calorie diet (VLCD) program for ≥4 weeks. Methods A mixed method study using the method perspective was conducted to analyse individual semi‐structured interviews conducted via videoconference and cross‐sectional survey data. Australians 18 to 65 years were eligible if they were currently consuming at least one VLCD product daily for ≥4 weeks or had ceased consumption within 4 weeks. Interviews were thematically analysed. Results Weight loss (19 kg [SD: 18 kg]) and duration (5 months [SD: 5 months]) of VLCD product use of the 31 participants (female: 97%, 44 [SD: 11] years, body mass index >30 kg/m2: 84%) were strongly correlated (r = 0.73, P < .001). Participants' experiences were influenced by a journey of learning from their previous weight loss attempts, discerned the VLCD program as credible, and chose to commence the VLCD due to a convergence of internal motivators. Early health‐related outcomes were a reinforcing stimulus and participants developed new health behaviours but felt dependent on the VLCD long term. Throughout these experiences the participants identified various individual, program structure, and environment related factors which either facilitated their VLCD program use or created barriers to achieving their goals. Health care professionals were minimally engaged. Conclusions A model of care to support facilitators and overcome barriers would mean more meaningful engagement of health care professionals to ultimately improve the experience and adherence of the VLCD program users in Australia.

‘The fact that I know I can do it is quite a motivator now’: a qualitative study exploring experiences maintaining weight loss 6 months after completing a weight loss programme for knee osteoarthritis

“…It is notable that many of our participants were still regularly using meal replacement products in the 6 months after the programme had ended, some of whom were still replacing two meals per day and following principles of the ketogenic restriction phase of the diet. This reflects the findings of a recent mixed-methods study that explored experiences of Australians who followed a VLCD 51. It found that people felt dependent on the VLCD in the long-term as they were afraid of regaining the weight they had lost, and of losing the benefits that had been achieved.…”

“…This reflects the findings of a recent mixed-methods study that explored experiences of Australians who followed a VLCD. 51 It found that people felt dependent on the VLCD in the long-term as they were afraid of regaining the weight they had lost, and of losing the benefits that had been achieved. This is a potentially undesirable finding given that the ketogenic restriction phase of the diet is not usually advocated for long-term use 52 due to the potential negative effects on electrolyte balance, hypotension and gallstones.…”

Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support

“…Despite no statistical improvement, overall QoL and all domains of QoL in the ESG group were clinically meaningful and further research with large sample sizes is needed to confirm the finding. Although causation cannot be inferred, the moderate correlations between QoL and %EWL suggests there may be many factors influencing QoL improvements following bariatric procedures, a finding which aligns with lifestyle obesity treatments [ 57 ]. In depth qualitative research has revealed that weight loss following bariatric surgery has led to complex changes in self-perception as well as impacting upon relationships, which are closely aligned with mental health and quality of life [ 58 ].…”

Real world evidence on the characteristics of regular and intermittent users of a very‐low calorie diet program and associations with measures of program success, health, and quality of life

“…2 Scale scores ranged from 0 to 21, with larger scores indicating adverse mental health scores; depression: normal (0-4), mild (5-6), moderate (7-10), severe (11)(12)(13), extremely severe (14þ): anxiety; normal (0-3), mild (4-5), moderate (6-7), severe (8-9), extremely severe (10þ); stress: normal (0-7), mild (8-9), moderate (10)(11)(12), severe (13)(14)(15)(16), extremely severe (17þ).…”

“…A previous mixed methods study identified several individuals (e.g., mental health), program (e.g., program structure/levels), and environmental (e.g., online or HCP support) barriers and facilitators which may influence success and adherence to a VLCD program in Australian adults (n = 31). 13 Therefore, this study aimed to determine the demographic, eating, self-efficacy and program engagement characteristics of different types of VLCD users in Australia (regular vs. intermittent users) and the associations between these user characteristics and self-perceived program success on weight loss, QOL, mental health and physical health. It was hypothesized that user type (regular vs. intermittent use) would be related to different demographic, eating, self-efficacy, and engagement factors, which may relate to program success.…”