Designing a co-created intervention to promote motivation and maintenance of time-restricted eating in individuals with overweight and type 2 diabetes

Background: Time-restricted eating (TRE) is an intermittent fasting regimen limiting the con-sumption of food and beverages to the same daily time window suggested to improve glycemic control and body weight. Adoption and maintenance of TRE in daily living is important for investi-gating the effects of TRE and also, for the potential of TRE as a possible treatment strategy in the future.
Purpose: To design an appealing TRE intervention by exploring behavioral and social mechanisms impacting TRE adoption and maintenance among people with type 2 diabetes (T2D) and over-weight.
Method: Intervention development combined empirical data and the sense of coherence theory. Empirical data sources included seven workshops and eight semi-structured interviews with people with T2D and overweight, their relatives, and healthcare professionals (HCPs) based on theoretical and empirical assumptions about how the intervention will work. Descriptive qualitative data anal-ysis was conducted.
Results: The analysis suggested designing the TRE intervention in two phases: a short period with strict TRE, followed by a longer period focusing on adapting TRE to individual needs with support from HCPs, relatives, and peers. To reinforce TRE motivation and maintenance, HCPs should adopt a whole-person approach incorporating a focus on participants’ previous experiences and every-day life.
Conclusions and Implications: The findings serve as basis for formulating design features and content of TRE interventions. Applying this knowledge, future TRE interventions targeting people with T2D and overweight are likely to have improved retention rates and adherence to the target eating window.