Views, experience and adherence among pregnant women with gestational diabetes participating in a weight loss study (WELLBABE)

Aims To investigate the views and experience of pregnant women newly diagnosed with gestational diabetes mellitus participating in a 1200 kcal/day diet to achieve moderate weight loss (the WELLBABE study), and to explore barriers to and facilitators of adherence. Methods Twelve participants engaged in semi‐structured interviews after completion of the 4‐week diet. An interview schedule was devised using open‐ended questions guided by the Theoretical Domains Framework. Transcript responses were analysed thematically. Results Participants were anxious about their diagnosis of gestational diabetes, but concerns related to dieting in pregnancy were allayed by reassurance from the research team. Participants expected health benefits, improved knowledge and support from enrolling on the study. The participants’ primary motivator to diet adherence was their baby's wellbeing. Other facilitatory factors included improving their own health and reducing any future risk of diabetes. Trying to provide reliable results and receiving extra care also facilitated adherence. Partners, friends and family were an important source of social support and no barrier caused by concern about weight loss in pregnancy was encountered. Observed and experienced physical changes and feedback from the research team positively reinforced adherence. The main barrier was that learning new skills was initially time‐consuming. Conclusions Weight loss was acceptable to women with gestational diabetes provided with clear information about likely benefit. A randomized controlled trial of this intervention is now required, employing clear information and feedback of glycaemic benefit to facilitate efficacy. What's new? Pregnant women newly diagnosed with gestational diabetes mellitus found a moderately reduced calorie diet both achievable and acceptable. The participants’ main motivation for diet adherence was optimizing the wellbeing of their baby. Other facilitating factors included improvements in their own physical health, reducing future risk of Type 2 diabetes mellitus and helping the research team. Absence of any barrier attributable to partners, family and friends being concerned about weight loss in pregnancy was striking. These data provide a basis for design of a randomized controlled trial of weight loss as therapy for gestational diabetes.