Table 1.
Session schedule for common elements in both intervention arms
| Session | Dietary topics | Psychology topics |
|---|---|---|
| Core sessions | ||
| #1 | Study description, background on PCOS, rationale of assigned diet, basic information about assigned diet, changing snacks and breakfasts, calculating net carbs and calories, side effect guide | Connecting with community |
| #2 | What happens to body when eating assigned diet, changing lunches, tracking diet, reading nutrition labels, menu makeover, tracking urinary ketones (for keto group) | Mindful eating |
| #3 | Changing dinners, eating on a budget, food substitutions | Awareness of cravings and triggers |
| #4 | Set yourself up for success, sugar and artificial sweeteners | Awareness of hunger and fullness |
| #5 | Diet-friendly foods, meal prepping and batch cooking, how to plan and eat when dining out or traveling | Small and doable goals |
| #6 | Physical activity and sleep, dealing with setbacks and challenges | Relaxation through breathwork |
| #7 | Recap of diet-friendly foods, weight loss plateaus | Self-compassion |
| #8 | Guide for problem solving, sticking to the diet | |
| #9 | Dealing with triggers, speaking with loved ones about support, holiday foods | Boosting mood by paying attention to “feel good” moments |
| #10 | Self-sabotage | Supporting oneself, recognizing personal strengths and preferences |
| #11 | New recipes, quick meals | Accessible and enjoyable activities for self-care |
| #12 | Recovering from setbacks, hidden carbohydrates (for keto group) | Positive reappraisal |
| #13 | Effect of insulin on weight, tips to stay successful, food sensitivities | Reframing unhelpful thoughts |
| #14 | Keto-friendly foods at restaurants, health problems related to sugar | “Best possible self” activity and identifying goals |
| #15 | Revisiting traveling while on a diet, review of information about assigned diet | Gratitude practice |
| #16 | Tools to help with sticking to and enjoying the program | Three funny things activity |
| Maintenance sessions | ||
| #1 | Reflection on how diet is going and favorite recipes | Using HALT: Hungry/Habit, Angry/Anxious, Lonely, or Tired/Thirsty |
| #2 | Substitutes appropriate for the diet | Managing stress through the four A’s: accept, alter, adapt, avoid |
| #3 | Grocery store walkthrough | Using guiding thoughts and images for motivation |
| #4 | Reviewing diet-friendly foods and reflecting on favorite foods | Mini meditations for calming and mindfulness during eating |
| #5 | Reviewing sweeteners, hunger and cravings | Managing setbacks |
| #6 | Make-ahead recipes | Non-food rewards |
| #7 | Diet-friendly celebratory foods, dealing with parties and social situations with food | Exploring one’s values |
| #8 | Review of diet-friendly foods, review of finding and tracking nutrition for foods | Reflecting on most helpful strategies |