Exploring the experience of time-restricted eating in veterans with spinal cord injury and obesity: a qualitative study.

Abstract

Veterans with spinal cord injuries (SCIs) have high prevalence of obesity, nearly 80%. New approaches to weight loss include time-restricted eating (TRE), defined as consuming all calories in a consistent time period of ≤ 10-hours daily. TRE has demonstrated weight loss and rehabilitation benefits in general populations. Recently, we conducted a feasibility trial of 10-hour TRE among Veterans with SCI and obesity, and conducted exit interviews to understand individuals' experiences while participating in TRE. We recruited Veterans with chronic SCI, paraplegia, and obesity. Veterans were interviewed after completing (<i>N</i> = 14) or withdrawing (<i>N</i> = 1) from the trial. We conducted thematic analysis of verbatim interview transcripts. Veterans were predominantly male, white (> 85%), and > 60 years old. We identified 5 key themes: motives for adopting TRE (primarily weight loss), TRE participation experiences (often positive, but with an initial transition that became easier over time), dietary changes (little impact on diet quality, but notable impact on diet quantity), perceived health changes (both positive and negative), and future TRE plans (for many, to continue TRE with modifications). Among Veterans with SCI and obesity, there may be unique barriers (like medication management and bowel care) and unique facilitators (like a striking similarity in weekday and weekend routines) that impact participation and adherence to TRE. With insights from the lived experiences of Veterans, TRE has the potential to be modified and adopted after SCI to improve dietary and rehabilitation outcomes.