A qualitative study of the views on weight management in overweight and obese Chinese diabetic patients

Abstract

INTRODUCTION Weight reduction was found to be associated with improved glycemic control among overweight and obese adults with type 2 diabetes mellitus (DM). However, obesity and overweight remains a significant problem for diabetic patients, as their motivating factors and barriers for weight reduction are diverse and complex. This qualitative study aims to investigate the motivating factors and barriers in weight control among obese DM patients. METHOD Twenty in-depth semi-structured interviews with obese or overweight diabetic patients under the care of Ap Lei Chau Clinic were conducted in 2013/2014. Issues like perceived barriers, facilitators, and their experience in weight and DM management were explored. All the interviews were audio-taped and transcribed into English, typed verbatim. Grounded theory approach was adopted and saturated data were analyzed thematically. RESULTS Four key themes were identified: (1) patients’ medical conditions, (2) psychological factors, (3) social support and (4) lifestyle habits. Co-morbidities like OA knee hinder regular exercise. Self-perception of health and weight influences the compliance to weight control. Dieting is preferred over exercise for weight reduction. Social and family support can assist patients to monitor their weight and facilitate adherence to appropriate choices and amount at meals. Patients who tried nutritional counselling before often considered the advice form dietitians are unpractical and difficult to apply. DISCUSSION Lifestyle modifications play a significant role in weight management of DM patients. However, patients’ self-perception and support from family is equally important. Nutritional counselling should be more tailor-made for individual patients, and considering of co-morbidities is equally crucial.