50-LB: Perceived Control over Eating Improves following Initiation of Carbohydrate-Restricted Nutrition Therapy in a Continuous Remote Care Model

Background: Nutrition is an important component of metabolic disease prevention and treatment, yet eating and perceived control over eating (PCOE) are complex behaviors. Most people who attempt lifestyle changes have setbacks that can interfere with confidence and motivation for sustained change. The Virta Health virtual clinic provides medically-supervised nutrition therapy for metabolic disease focused on carbohydrate restriction and provides education and tools to: (1) understand how foods impact metabolic health; (2) facilitate autonomy for food choices; and (3) disentangle physiological and emotional food cues, to foster patients’ eating confidence even if they struggle with adherence. This analysis explored whether Virta patients’ PCOE improved during early treatment as these concepts were taught. Methods: As part of standard clinical care, Virta patients (N=5940, Mean (M) age = 54 years, 72% white, 61% female, 73% T2D, M BMI = 36) responded to 4 items (total score range 4-20) assessing PCOE before the dietary intervention and at follow-up (M days = 60, SD = 15) . Paired t-tests were conducted to assess changes in PCOE over time among all patients and separately within subgroups based on dietary adherence (M ketones during treatment ≥ or < 0.5 mM) . Results: PCOE improved from pre-treatment (M=13.3, “slightly” in control) to the first follow-up (M=15.7, “somewhat” in control) in all patients (p