Participant experiences of a low-energy total diet replacement programme: A descriptive qualitative study

Abstract

Introduction The participants' experience of low-energy total diet replacement (TDR) programmes delivered by lay counsellors in the community for the routine treatment of obesity is currently unclear. We interviewed a sample of twelve participants who took part in the Doctor Referral of Overweight People to Low-Energy total diet replacement Treatment (DROPLET) trial and were randomised to the TDR programme. Methods We purposively sampled twelve patients who took part in the DROPLET trial, and conducted in-depth telephone interviews, which were audio-recorded and transcribed verbatim. Interview questions focused on participants' experiences and perceptions of the TDR programme. We conducted a thematic analysis, actively developing themes from the data, and used the one sheet of paper (OSOP) technique to develop higher-level concepts. Results Nine key themes were identified; Reasons for taking part, Expectations, Support and guidance from the counsellor, Time to build a personal relationship, Following the TDR Programme, Adverse events, Outcomes from the TDR, Weight Loss Maintenance, Recommending TDR to others. The relationship between participants and the counsellor was central to many of the themes. Close relationships with counsellors facilitated TDR adherence through providing one-to-one support (including during difficult times), sharing expert knowledge, and building a close relationship. Adherence was also supported by the rapid weight loss that patients reported experiencing. Overall participants reported positive experiences of the TDR, and emphasised the positive impact on their wellbeing.

Dietary adherence and program attrition during a severely energy-restricted diet among people with complex class III obesity: A qualitative exploration

“…This research confirms previous findings from qualitative research studies that investigated the experiences and the acceptability of total meal replacement VLEDs for participants with overweight and obesity [23,[26][27][28][29]. The common facilitating factors to positive adherence are: SERD group counselling and psychoeducation sessions (1.1), emotionally supportive clinical staff and social networks that accommodate and champion change in dietary behaviours (1.2) and dietary simplicity, planning and self-monitoring (1.5).…”

“…This includes self-imposed unrealistic weight-loss expectations [57], poor program accessibility related to socioeconomic disadvantage (such as the inability to purchase meal replacement products and cost of transport to the weight loss service) [58,59], weightrelated stigma [60,61] and depression [62]. The cost of purchasing meal replacement products has previously been identified as a factor leading to poor dietary acceptability and poor adherence in two previous qualitative studies [26,27], and our investigation extends this finding by demonstrating its presence among patients with complex class III obesity. Thus, dietary adherence is affected by many factors, which are unrelated to the type of dietary intervention.…”

An exploratory qualitative study of the prevention of road traffic collisions and neurotrauma in India: perspectives from key informants in an Indian industrial city (Visakhapatnam)

“…A descriptive qualitative approach was utilised for this study as the focus was to learn about the key informants’ perspectives rather than the generation of theories [ 18 , 19 ]. As an approach that allows the researcher to remain close to the data and the surface of words and events, qualitative description allows for obtaining straight answers to issues of relevance to practitioners and policy makers where this method has been shown to be useful for developing and refining interventions [ 18 , 20 ].…”

Prevention of road traffic collisions and associated neurotrauma in Colombia: An exploratory qualitative study

“…The completed checklist is available in the S1 File . The descriptive approach was selected as this study sought to learn about people’s perspectives or experiences of phenomenon, rather than theory-generation [ 25 , 26 ]. This approach enables the researcher to stay close to participants’ viewpoints on a particular issue or phenomenon and provide a rich description of the experience in easily understood language [ 27 ].…”

“…The transcripts were analysed manually by thematic analysis using a framework approach [28]. As an analytical approach that sits within the broad family of thematic analysis and is not aligned to any particular philosophical or theoretical approach, this method is suitable for qualitative descriptive studies where it allows for straightforward, transparent results that remain close to the 'surface of the data', and is shaped by existing ideas without the need to produce a new theory [25,[27][28][29][30]. This approach can also be easily applied without the need for qualitative data analysis software [29].…”