Type 1 Diabetes Is a Barrier to Obesity Treatment: Patient Insights From a Mixed-Methods Study

Background: Globally, many patients with Type 1 diabetes (T1D) are now characterized by excess adipose tissue and features of insulin resistance. In Kuwait, rapid urbanization, shifts in dietary patterns, and decreased physical activity have contributed to rising obesity prevalence in the general population. Objectives: We aimed to investigate the interplay between the diseases of obesity and T1D, examining patients' perspectives on why they gained body weight, psychological aspects, and management challenges. Methods: A mixed-methods approach was employed, encompassing quantitative analysis of body mass index (BMI) and lifestyle factors among 51 participants with T1D and obesity or obesity-related complications and a thematic analysis of perceptions and experiences related to obesity and T1D using an online survey. Results: Participants identified lifestyle factors as the primary contributors to obesity, emphasizing the need for holistic interventions. About 56.8% of the participants perceived T1D as a barrier to obesity treatment. The qualitative analysis revealed four themes: 1) negative perceptions about obesity, 2) poor interface with healthcare professionals (HCPs), 3) lack of suggestions for improving obesity management, and 4) poor self-image and awareness. This provided in-depth insights into participants' perceptions, worries, experiences, and suggestions for managing obesity in the context of T1D. Conclusions: This study contributes a nuanced understanding of obesity in patients with T1D, shedding light on the complexities beyond glycemic control. The findings emphasize the need for patient-centered, multidisciplinary approaches that consider both medical and psychological aspects in the management of obesity within patients with T1D.