'The fact that I know I can do it is quite a motivator now': a qualitative study exploring experiences maintaining weight loss 6 months after completing a weight loss programme for knee osteoarthritis

Abstract

Objective: To explore experiences maintaining weight loss 6 months after completing a multicomponent weight loss programme for knee osteoarthritis.

Design: Qualitative study based on an interpretivist paradigm and a phenomenological approach that was embedded within a randomised controlled trial.

Setting: Semistructured interviews were conducted with participants 6 months after completing a 6-month weight loss programme (ACTRN12618000930280) involving a ketogenic very low calorie diet (VLCD), exercise and physical activity programme, videoconferencing consultations with a dietitian and physiotherapist, and provision of educational and behaviour change resources and meal replacement products. Interviews were audio recorded, transcribed verbatim and data were analysed based on the principles of reflexive thematic analysis.

Participants: 20 people with knee osteoarthritis.

Results: Three themes were developed: (1) successfully maintained weight loss; (2) empowering self-management of weight (understand importance of exercise; increased knowledge about food and nutrition; resources from programme still useful; knee pain as a motivator; confidence in ability to self-regulate weight) and (3) challenges keeping on track (loss of accountability to dietitian and study; old habits and social situations; stressful life events or changes in health).

Conclusion: Participants had overall positive experiences maintaining their weight loss since completing the weight loss programme and were confident in their ability to self-regulate their weight in the future. Findings suggest a programme incorporating dietitian and physiotherapist consultations, a VLCD, and educational and behaviour change resources supports confidence maintaining weight loss in the medium term. Further research is required to explore strategies to overcome barriers like loss of accountability and returning to old eating habits.

Keywords: knee; nutrition & dietetics; pain management; qualitative research.