Behavioral weight-loss treatment plus motivational interviewing versus attention control: lessons learned from a randomized controlled trial

Erin L Moss,Leah N Tobin,Tavis S Campbell,Kristin M Von Ranson

doi:10.1186/s13063-017-2094-1

Erin L Moss, Leah N Tobin + Show 2 more

Open Access

https://doi.org/10.1186/s13063-017-2094-1

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Abstract

BackgroundStudies evaluating the benefit of adding motivational interviewing (MI) to behavioral weight-loss programs (BWLPs) have yielded mixed findings.MethodsThe aims of this randomized controlled trial were to: (1) assess the efficacy of adding MI to a BWLP on weight loss and adherence among 135 individuals with overweight and obesity (77.8% female; mean BMI = 33.6 kg/m2) enrolled in a 12-week BWLP and (2) explore levels of importance, confidence, and readiness for change ratings.ResultsParticipants, who were randomized to receive two MI sessions or two attention control sessions, were assessed at baseline, the end of the BWLP, and 6 months post BWLP. Both groups decreased their weight from baseline to the end of the BWLP; however, there was no weight change in either group when measured between baseline and 6 months post BWLP. We observed no group differences in importance, confidence, and readiness for change after each session.ConclusionsWe highlight some important lessons learned from the present trial that can be applied to MI + BWLP research. Participants may not have benefited from MI because they were already highly motivated to change, which highlights the importance of pretreatment assessment. Findings also suggest that treatment monitoring may help to enhance MI + BWLP efficacy by guiding a stepped-care approach that identifies individuals for whom additional MI sessions are needed, and when. A focus on refining elements of treatment remains an important direction.Trial registrationClinicalTrials.gov, Identifier: NCT02649634. Retrospectively registered on 5 January 2016.

Highlights

Studies evaluating the benefit of adding motivational interviewing (MI) to behavioral weight-loss programs (BWLPs) have yielded mixed findings
We investigated the effect of administering motivational interviewing (MI) to adults with overweight and obesity who had already voluntarily enrolled in a behavioral weight-loss program (BWLP)
MI may have promise in the treatment of obesity, further research to isolate specific elements and patient characteristics that contribute to improved MI outcomes is essential

Summary

Introduction

Studies evaluating the benefit of adding motivational interviewing (MI) to behavioral weight-loss programs (BWLPs) have yielded mixed findings. Obesity, which places a large economic burden on health care systems due to medical complications [1], can be addressed through public health and behavioral interventions. We investigated the effect of administering motivational interviewing (MI) to adults with overweight and obesity who had already voluntarily enrolled in a behavioral weight-loss program (BWLP). MI is a counseling strategy that aims to assist and motivate individuals in moving towards behavioral change. BWLPs attempt to address environmental causes of obesity by increasing energy expenditure and decreasing energy intake through behavioral changes, and are usually the first line of weight-loss treatment [4]. A BWLP typically includes dietary intervention, physical activity change, and behavioral self-management [5, 6]

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