The role of social support in achieving weight loss in adults in the Caribbean aiming to achieve remission of type 2 diabetes: A cross-case analysis

Abstract

Background: Remission of type 2 diabetes through weight loss is possible in a high proportion of persons with a recent diagnosis, but a major challenge is achieving sufficient weight loss. Objectives: In the first study of this type in the Caribbean, we investigated factors associated with successful weight loss in adults in a diabetes remission intervention. We hypothesized that differences in social support may have influenced differences in weight loss achieved by participants in the Barbados Diabetes Reversal Study (BDRS). Methods: A comparative case study was conducted. Quantitative data for the primary outcome measure of weight reduction (the participants baseline and 8-month weights) were assessed to identify the 6 participants with the highest and 6 participants with the lowest weight loss. The 8-week (low-calorie diet phase) and 8-month (weight maintenance phase) interview transcripts for each participant were then analyzed via qualitative thematic analysis to explore factors related to social support. Results: Informal and formal support were identified for both categories of participants. Cases were similar with respect to their sources of support however dissimilarities were found in (1) the depth of support received; (2) access to supportive environments and (3) diversity of social supportive networks. Participants in the top weight loss group reported consistency in the levels of support received over the low-calorie diet and weight maintenance phases of the study while the converse was true for those of the bottom weight loss group. Conclusion: Study findings suggest that individuals aiming at type 2 diabetes remission benefit from strong social support networks. These networks provide tangible assistance and facilitate the sharing and discussion of strategies for weight reduction. Future studies should facilitate in-depth understanding of how formal and informal supportive networks can aid sustained dietary diabetes remission and long-term weight maintenance.