A qualitative study of enablers and barriers to healthy eating in adults with Charcot Marie Tooth disease using the Theoretical Domains Framework and COM-B model

Charcot-Marie-Tooth disease (CMT) is a progressive neurological disorder affecting the peripheral nervous system, with symptoms such as fatigue, pain and muscle weakness that can hinder engagement in health-promoting behaviours, including healthy eating. This study explored enablers and barriers to healthy eating among adults with CMT, using the Theoretical Domains Framework (TDF) and the COM-B model. Twenty-two semi-structured interviews were conducted with 17 women and 5 men (aged 25-73). Data were analysed using framework analysis. Identified barriers included symptom-related fatigue, particularly during periods of high demand (e.g. workdays), limited lifestyle-focused guidance in routine healthcare interactions and physical environmental constraints. Key enablers comprised meal planning, social support from family and online communities, recognition of the mental and physical benefits of healthy eating and access to resources that helped mitigate physical limitations. These findings provide a foundation for developing evidence-based, context-sensitive dietary interventions tailored to the lived experiences of individuals with CMT.