Understanding Preferences for Weight Loss Diets Amongst Patients With a Diagnosis of Type 2 Diabetes.

INTRODUCTION: Weight control is a cornerstone of Type 2 Diabetes (T2D) management. The low-calorie diet program continuous low energy diets (CLED) is currently offered to patients for remission in the United Kingdom, but this may not suit all patients. Intermittent Low Energy Diets (ILED) may be an alternative approach. This survey explored patient characteristics and dietary choice priorities to predict preference for CLED, ILED, and other diets to inform future patient-centered advice. METHODS: 622 participants (> 18 years) with a diagnosis of T2D recruited via a patient volunteer database, social media and the Prolific research register completed an online survey. Demographics, health characteristics, T2D treatment factors and dietary choice priorities were analyzed to predict preference between CLED and ILED. In addition, we explored qualitative reasons why participants were choosing between these two diets as well as other calorie-restricted diets. RESULTS: CLED preference was significantly higher among all the < 65 age groups (than those aged > 74), and those who prioritized reduced medicine dependency (1.75 times more likely) and prioritizing speed of weight loss (2.59 times more likely) over improving blood sugar. ILED preference was associated with prioritizing flexibility of food choice (2.73 times more likely) and prioritizing diets which fit in with family meals and social events (2.5 times as likely) over professional support. Content analysis showed that CLED and ILED diets weren't the most popular dietary choice, with more patients expressing preferences for a daily food based moderate calorie-restricted diet and low carbohydrate diets. Simplicity to follow was a common theme across all diets, demonstrating the importance of ensuring that any prescribed diet has clear and easy instructions. CONCLUSION: Patients' dietary preferences are influenced by a range of factors including the outcome and the extent to which the diet will fit into their lifestyles. Understanding patient perspectives about desired dietary outcomes and how they envisage the diet fitting into their lives will enable professionals to provide helpful patient-centered advice which may increase the likelihood of adherence.