Work

Understanding Participant Experiences During the Very Low-Calorie Diet Phase of a Diabetes Remission Trial in Singapore: A Reflexive Thematic Analysis

Year: 2026

Type: article

Abstract: Background/Objective: Research in the past decade has shown that targeting obesity in patients with type 2 diabetes mellitus can bring about multiple health benefits, including diabetes remission. This study explores the barriers and facilitators affecting behavior changes for weight loss in obese individuals with early Type 2 diabetes who completed a very low calorie diet (VLCD) intervention in diabetes remission clinical trial. Methods: A qualitative study embedded within the clinical trial conducted in 4 public primary care clinics located in central north region of Singapore. Semi-structured in-depth interviews, guided by the Capability Opportunity Motivation and Behavior model of behavioral change, were conducted after participants had completed 12 weeks of VLCD. Transcribed narratives were analyzed using a thematic approach. Results: Six themes emerged from participants' experiences during VLCD: 1) Integral support framework for weight management, 2) Improved Sense of Well-Being through weight loss, 3) Psychological barriers to adhering to a calorie-restricted diet, 4) the Unique Singaporean way of life, 5) Seeking tasty food options during VLCD and 6) Retaining knowledge, not the weight. These themes were inter-related, reflecting a dynamic process where personal motivations, environmental, and cultural factors collectively influenced behavior change. Discussion: This study identified distinct barriers and facilitators relevant to Singaporeans undergoing VLCD. It highlights the importance of providing a robust support system that addresses cultural and social factors to facilitate adherence to VLCD. The awareness, knowledge, and experiences acquired during VLCD play an important role in empowering participants to remain committed to their health goals and maintain long-term behavioral changes.

Source: AACE Endocrinology and Diabetes

DOI: 10.1016/j.aed.2026.02.017

Authors: Andrew Yew Weng Lee, Shu Yun Tan, Sabrina Poay Sian Lee, Shannon Yi Xuan Goh, Wern Ee Tang

Institutions: National Healthcare Group, NHG Polyclinics

Language: English

Topic: Diabetes Management and Education

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funder: Tanoto Foundation