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Table 2 Examples of meaning units for the main themes and subthemes

From: Initiation and maintenance of lifestyle changes among participants in a healthy life centre: a qualitative study

Main ThemesSubthemesMeaning Units [Valence]
Motivational basis for changeControlled versus autonomous motives for healthy behaviourOf course, I had thoughts that I should go for walks and eat healthy. But it hasn’t been, like, for real. Not an urge, nor an extra feeling that I should do it. It has just been a standard, yes, but you should do this and should really … (5,M,20–25) [Negative]
It was not me who made contact directly, it was my father. He is a doctor … he thought it was for me, and he signed me in … It was a surprise to me … I wanted better health … one looks better with better health … If I could get hypnotized, and just fixed in a snap, it would be brilliant. (4,M,30–35) [Negative]
The reason all this started is that I realized that much of this is about my health. And I am not going to the Olympics … Health is for me to feel that the everyday tasks are OK, with no fuss of being too heavy … So, health is that I can function … (13,F,45–50) [Positive]
I just want to live, to have more energy in a way. More, feel that I am a healthy, strong man. (9,M,35–40) [Positive]
Relational supportThat course was a gift from above … because there are so many pitfalls to tremble in … so it has been amazing … and I have learned about exercise and we had an exercise session after class that was fantastic. (14,M,35–40) [Positive]
It was good to come here, something to go to every week, having the focus … Now I have stopped everything … maybe due to not coming here (the HLC), not committing …. Not many offerings for fat and slow people. (3,M,50–55) [Negative]
Coping for emotional balanceCognitive appraisalsI drank my first glass of water in a very long time. It has mostly been Coke. Previously I have thought “yucky” - it tastes like nothing … But this time when I drank the water, I imagined the liver and kidneys cheering and enjoying themselves. Finally, something clean … It was not as good as Coke of course, the first time. But at least someone was happy. (14,M,35–40) [Positive]
But there is a kind of perfectionism in it, which implies that if it is not perfect – no, then we must throw it all away. Zero or nothing almost. I wish I could control it and manage it. Because if I could then I would know that 95 is just as good as 100, everything is better than 0, even if it was 30 or 20 or 1, it is better than 0. But I cannot manage because when it starts to crumble, below 100, closer to 90, closer to 80 – my motivation withers and it falls apart. (5,M,20–25) [Negative]
All this of being fat and overweight is kind of shameful because it is a societal focus on the body … Why don’t you pull yourself together and do something about it? Like, you’ll die of it. So it is very coated with shame because it involves your identity. Like who are you? Okay, when you let it slip there, how are you in other areas? Are you stupid? … You are almost expected to run a marathon before anyone bothers to talk to you … (3,M,50–55) [Negative]
Behavioural adjustmentsI have had an eating disorder … but I have it mostly under control now … when you are full you are full – you don’t have to eat until you throw up … Still, if I have a bad day or a painful emotion then I want to go home and eat chocolate pudding … now I go for a walk … take a shower … eat vanilla protein pudding … Find other ways to cope. (6,F,20–25) [Positive]
Self-regulation skillsGoal settingI had a goal to reduce my weight … Then I tried to think about waist circumference because that was smart. But the conclusion was that, in the end, I was not going to have any goals regarding kilograms at all, I have to focus on lifestyle … if I focus on that and manage to adhere for the long-term then I will decrease weight anyway. (9,M,35–40) [Neutral]
Creating space for new behavioursI care a lot for people, for good and bad, right. I do not think it has changed, I have just become more aware of, even if you are a kind person you do not have to put yourself last. I used to do that. (6,F,20–25) [Positive]
It is rolling back to my old life … I am not getting it done … I must look after my job … Life gets in the way, so to speak. (3,M,50–55) [Negative]
It is an epiphany when you realize that your children understand that you must (spend time exercising), you need this. Like, you don’t have to feel bad. 1,F,55-60 [Positive]
Monitoring satisfaction with outcomesIt would be great if one could get motivation from others, but basically you must be aware of getting motivated yourself. You get that if you work out and experience the joy it gives, then you feel more vigilant, happier. When you eat healthy you feel more vigilant. (1,F,55–60) [Positive]
The tests were good, I liked them … It was useful to get these, literally, what you need. And maybe look fat percent related to what you managed of the exercise stuff … push ups and things I could do. (8,F,60–65) [Positive]
In those assessments, you get confronted with a shameful side of yourself. Which is kind of good because it forces you to, it gets clearer than when pushed aside … (3,M,50–55) [Neutral]