Motivation For Weight Loss Research Articles

Personal motivation, self-regulation barriers and strategies for weight loss in people with overweight and obesity: a thematic framework analysis.

To explore motivations, self-regulation barriers and strategies in a multi-ethnic Southeast Asian population with overweight and obesity. Qualitative design using semi-structured face-to-face and videoconferencing interviews. Data were analysed using thematic framework analysis and constant comparison method. Specialist weight management clinic. Twenty-two participants were purposively sampled from 13 April to 30 April 2021. Median age and BMI of the participants were 37·5 (interquartile range (IQR) = 13·3) and 39·2 kg/m2 (IQR = 6·1), respectively. And 31·8 % were men, majority had a high intention to adopt healthy eating behaviours (median = 6·5; IQR = 4·8-6·3) and 59 % of the participants had a medium level of self-regulation. Six themes and fifteen subthemes were derived. Participants were motivated to lose weight by the sense of responsibility as the family's pillar of support and to feel 'normal' again. We coupled self-regulation barriers with corresponding strategies to come up with four broad themes: habitual overconsumption - mindful self-discipline; proximity and convenience of food available - mental tenacity; momentary lack of motivation and sense of control - motivational boosters; and overeating triggers - removing triggers. We highlighted six unique overeating triggers namely: trigger activities (e.g. using social media); eating with family, friends and colleagues; provision of food by someone; emotions (e.g. feeling bored at home, sad and stressed); physiological condition (e.g. premenstrual syndrome); and the time of the day. Future weight management interventions should consider encompassing participant-led weight loss planning, motivation boosters and self-regulation skills to cope with momentary overeating triggers.

Pre-Liver Transplant Patient Perception of Current Weight and Weight Loss Motivation

Pre-Liver Transplant Patient Perception of Current Weight and Weight Loss Motivation

Identifying Indicators of the Construct for Motivation for Weight Loss: Designing a Questionnaire

The prevalence of overweight and obesity is rising rapidly throughout both the developed and the developing world, and it is creating social, economic and health burden on society particularly in urban areas (Popkin, 2006 in Tesfalem, 2013). As a part of designing a questionnaire, the current research aims to identify the indicators of the latent construct motivation for weight loss. To achieve this, the paper raised the following two specific research questions: What are the indicators of the motivation for participation for weight loss program? And where do the indicators fit in the factors of social determination theory (SDT)? To gain a rich understanding of the motivation for the participation in weight loss program, semi-structured focus group discussions (FGD) were conducted with purposely recruited samples of two groups: overweight people and their interventionists. Based on the themes identified from the FGD the indicators were identified. Besides, from the consultations gained from the review of related literature the indicators were placed in SDT. Keywords: Overweight, Weight loss, Motivation, Self-Determination Theory (SDT) DOI: 10.7176/JEP/12-28-03 Publication date: October 31 st 2021

Nutrition education via “instagram” and motivational interviewing for weight loss motivation and physical activity in obese female students

Nutrition education and motivational interviewing are methods to increase motivation, as essential factors in increasing physical activity. The purpose of this study was to determine the effect of nutrition education via Instagram and motivational interviewing, on weight loss motivation and physical activity of obese female students. This study was quasi-experimental with a pre-post-controlled group design that involved thirty-seven obese female students aged 18-23 years at Universitas Diponegoro, selected by proportional stratified sampling. Subjects were divided into three groups, P1 was given nutrition education via Instagram for 30 days (ED) and motivational interviewing four times (MI), P2 was given ED only, and the control (K) was given a leaflet. Weight loss motivation was measured using a healthy diet motivation questionnaire, and physical activity (PA) was measured using IPAQ-SF. Data were analyzed using one way ANOVA, Kruskal Wallis, paired t-test, Wilcoxon, and Mann Whitney. There was an increase in the mean of weight loss motivation that highest in group P1 (109.86 into 126.43), followed by group P2 (114.85 into 121.69) and group K (105.30 into 112.90). The highest increase in the mean of total physical activity was in the P1 group (1341 to 2572), the P2 group (1761 to 2378), and the K group decreased (3404 to 1987) in METs units. There was a significant difference in the mean change in total physical activity and moderate physical activity between P1 and P2 groups when compared to the K group.

Social Support for Diet Communities in Social Media

The number of users of social media in Indonesia has the potential to control global epidemiological problems including obesity. Does the group formed on social media, that consists of people who do not know each other, but because of the similarity of interest in losing weight, will help increase the motivation of the group members? The purpose of this study was to find a relationship between friend sup- port on social media with increased motivation in weight loss. This research is descriptive analytic, with cross sectional design. A sample of 110 people was selected using a purposive sampling technique. The research instrument was adopted from the Treatment Self-Regulation Questionnaire (TSRQ) and the Ballatine questionnaire. The results showed 88.2% of respondents were women, 85.5% were aged 20-40 years, most were housewives (50.9%), the period of joining groups on social media between 1-4 months (45.5%). About 49.1% of respon- dents felt strongly supported and motivated by members in fellow groups on social media. The statistical test results show that there is a relationship between social support and motivation for weight loss (pValue 0.019). This study shows that groups on social media can help maintain the motivation of their members to carry out a diet. It is recommended that health promotion personnel to use social media as an alternative to disseminating health program information.

Patient motivation to lose weight: Importance of healthcare professional support, goals and self-efficacy

BackgroundPeople with obesity (PwO) often struggle to achieve and maintain weight loss. This can perpetuate and/or be influenced by feelings of low motivation. This analysis from ACTION-IO data identified factors associated with PwO motivation to lose weight. MethodsPwO completed an online survey in 11 countries. Exploratory multinomial logistic regression analyses identified independent variables associated with self-report of feeling motivated versus not motivated to lose weight. ResultsData from 10,854 PwO were included (5,369 motivated; 3,312 neutral; 2,173 not motivated). Variables associated with feeling motivated versus not motivated included (odds ratio [95% confidence interval]): acknowledgement of healthcare professional (HCP) responsibility to contribute to weight loss (2.32 [1.86–2.88]), comfort in talking to their HCP about weight (1.46 [1.24–1.72), agreement that it is easy to lose weight (1.73 [1.30–2.31]), and a goal of reducing risks from excess weight (1.45 [1.22–1.73]). Conversely, if PwO considered obesity less important than other diseases they were less likely to report feeling motivated (0.49 [0.41–0.58]). PwO who reported being motivated to lose weight were more likely to exercise ≥5 times a week versus <1 time a week (2.77 [2.09–3.68]) than those who reported they were not motivated. ConclusionsPositive interactions with HCPs, self-efficacy, setting goals and knowledge of the importance of weight management, in addition to regular exercising, may increase PwO motivation for weight loss. Appropriate HCP support may help PwO who are ready to engage in weight management. Clinical trial registration: NCT03584191.

Late eating is associated with cardiometabolic risk traits, obesogenic behaviors, and impaired weight loss

There is a paucity of evidence regarding the role of food timing on cardiometabolic health and weight loss in adults. To determine whether late eating is cross-sectionally associated with obesity and cardiometabolic risk factors at baseline; and whether late eating is associated with weight loss rate and success following a weight loss intervention protocol. Also, to identify obesogenic behaviors and weight loss barriers associated with late eating. Participants were recruited from a weight-loss program in Spain. Upon recruitment, the midpoint of meal intake was determined by calculating the midway point between breakfast and dinner times, and dietary composition was determined from diet recall. Population median for the midpoint of meal intake was used to stratify participants into early (before 14:54) and late (after 14:54) eaters. Cardiometabolic and satiety hormonal profiles were determined from fasting blood samples collected prior to intervention. Weekly weight loss and barriers were evaluated during the ∼19-wk program. Linear and logistic regression models were used to assess differences between late and early eaters in cardiometabolic traits, satiety hormones, obesogenic behaviors, and weight loss, adjusted for age, sex, clinic site, year of recruitment, and baseline BMI. A total of 3362 adults [mean (SD): age: 41 (14) y; 79.2% women, BMI: 31.05 (5.58) kg/m2] were enrolled. At baseline, no differences were observed in energy intake or physical activity levels between early and late eaters (P>0.05). Late eaters had higher BMI, higher concentrations of triglycerides, and lower insulin sensitivity compared with early eaters (all P<0.05) prior to intervention. In addition, late eaters had higher concentrations of the satiety hormone leptin in the morning (P=0.001). On average, late eaters had an average 80 g lower weekly rate of weight loss [early, 585 (667) g/wk; late, 505 (467) g/wk; P=0.008], higher odds of having weight-loss barriers [OR (95% CI): 1.22 (1.03, 1.46); P=0.025], and lower odds of motivation for weight loss [0.81 (0.66, 0.99); P=0.044] compared with early eaters. Our results suggest that late eating is associated with cardiometabolic risk factors and reduced efficacy of a weight-loss intervention. Insights into the characteristics and behaviors related to late eating may be useful in the development of future interventions aimed at advancing the timing of food intake.

Weight Loss Motivation in Older Pre-Diabetics: Preliminary Evidence by Race in the Eggspdite Study

Obesity hastens functional decline and intensifies chronic health conditions among older adults. Late-life obesity is of particular concern for older African Americans, who are at increased risk for obesity and type 2 diabetes and for whom weight loss interventions can be less effective. However, obesity interventions have been under-studied in this population; little is known about potential differences in motivation for change by race. The ongoing Eggs PreDiabetes Intervention Trial (EGGSPDITe) is a randomized controlled trial of expedited weight loss in older (60+ years) Black and White adults with prediabetes. Participants completed both the Stages- and Processes of Change questionnaires in Weight Management (S-Weight and P-Weight) at baseline and end of 4-month intervention. Preliminary combined-group analysis indicates that, while White participants reported a higher average stage of change at baseline, there was no difference by race (ps < 0.05) in changes for body weight, fat mass, and hemoglobin A1c at endpoint. Reductions in weight consequences evaluation (WCE) and increases in weight management actions (WMA) subscales were observed in both races (ps < 0.05), with a trend toward decreased emotional re-evaluation (EmR; p = 0.06). Of the processes of change subscales, only WCE differed by race (p < 0.05), with White participants showing ≈13.5% higher utilization, relative to Black participants, at both time points. These preliminary findings suggest that weight loss interventions can be equally effective among black and white older adults, although motivations for weight loss may differ by race.

Association between Health-Related Quality of Life and Emotional Problems in Rural Adolescents with Overweight and Obesity

Background: Health-related quality of life (HRQL) and emotional functioning are important parameters of weight-loss motivation. The aim of this study was to identify the association between emotional/personal characteristics and HRQL in adolescents with overweight and obesity. Methods and Results: Our cross-sectional case-control study included 172 adolescents: 19 of them overweight, 67 obese, and 86 healthy. We measured anthropometry and performed a psychological examination (PedsQL 4.0, The State-Trait Anxiety Inventory, Buss-Durkee Hostility Inventory, and Personality inventory Mini-SMIL). Negative correlations prevailed between PedsQL scales and psychological traits of healthy adolescents: increases in anxiety, covert anger, and depression were associated with a decrease of HRQL (Total Scale Scores, Psychosocial Health Score, Physical Health Score, and Emotional, Social and School functioning). The psychological impairment (Irritability, Resentment, Guilt, Covert anger) positively correlated with a change in HRQL (Total Scale Scores, Psychosocial Health Score, and Physical Health Score) in obese adolescents. Conclusion: Obese adolescents had an inadequate association between HRQL and emotional state: the accumulation of anxiety and aggression was accompanied by an increase in HRQL. These difficulties can be a barrier to having treatment and weight-loss motivation.

A systematic review and thematic synthesis of qualitative studies exploring GPs' and nurses' perspectives on discussing weight with patients with overweight and obesity in primary care.

SummaryGuidelines and evidence suggest primary care clinicians should give opportunistic interventions to motivate weight loss, but these rarely occur in practice. We sought to examine why by systematically reviewing qualitative research examining general practitioners' (‘GPs’) and nurses' views of discussing weight with patients. We systematically searched English language publications (1945‐2018) to identify qualitative interview and focus group studies. Thematic methods were used to synthesise the findings from these papers. We synthesised the studies by identifying second‐order themes (explanations offered by the original researchers) and third‐order constructs (new explanations which went beyond those in the original publications). Quality assessment using the Joanna Briggs checklist was undertaken. We identified 29 studies (>601 GPs, nurses and GP trainees) reporting views on discussing weight with patients. Key second‐order themes were lack of confidence in treatments and patients' ability to make changes, stigma, interactional difficulty of discussing the topic and a belief of a wider societal responsibility needed to deal with patients with overweight and obesity. The third‐order analytical theme was that discussions about weight were not a priority, and other behavioural interventions, including those relating to smoking, often took precedent. GPs and nurses reported that noting body mass index measurements at every consultation alongside a framework to deliver interventions would likely increase the frequency and perceived efficacy of behavioural weight interventions. GPs and nurses acknowledge the importance of obesity as a health issue, but this is insufficient, particularly amongst GPs, for them to construe this as a medical problem to address with patients in consultations. Strategies to implement clinical guidelines need to make tackling obesity a clinical priority. Training to overcome interactional difficulties, regular weighing of patients and changing expectations and understanding of weight loss interventions are also probably required.

THE RS1801282 PPARG POLYMORPHISM DEPENDENT METABOLIC EFFECTS OF PIOGLITAZONE IN PATIENTS WITH OBESITY AND CONCOMITANT NAFLD

The aim: to investigate the metabolic effects of different treatment options in patients with obesity and concomitant non-alcoholic fatty liver disease (NAFLD) based on the presence of CG and GG genotypes PPARG rs1801282 (Pro12Ala) polymorphism in Ukrainians. Materials and methods: 123 patients with NAFLD in combination with obesity 1, 2, 3 classes were included in the motivational weight loss program (5 visits, 3 months). The case group was treated with pioglitazone 15 mg / day, while the control group received only a program. Ultrasound steatometry, anthropometric and laboratory tests before and after treatment, genetic testing rs1801282 polymorphism in PPARG gene were performed. Results: the carriers of CG and GG genotypes PPARG rs1801282 polymorphism had less high stimulated insulin levels compared with groups of different genotypes (p&lt;0.001). It was found pioglitazone effectiveness with significant difference in dynamics of CAP reduction (p&lt;0.001) regardless of polymorphism. Dynamics of BMI decrease was the lowest in control group CC carries – –2.81 (–3.23; –2.39) kg (p&lt;0.001) compared among other groups. Subjects from pioglitazone group with rs1801282 polymorphism carrying of CG and GG genotypes had significant differences in dynamics of fasting С-peptide decrease, serum uric acid reduction – –1.31 (–1.50; –1.13) µg/L and -165.3 (–182.80; –147.80) µmol/L (p&lt;0.001) respectively compared among other groups. Conclusions: Better reduction of metabolic parameters during pioglitazone treatment of patients with obesity and concomitant NAFLD appears to be associated with carrying of CG and GG genotypes PPARG rs1801282 polymorphism.

'I have been all in, I have been all out and I have been everything in-between': A 2-year longitudinal qualitative study of weight loss maintenance.

Qualitative studies investigating weight management experiences are usually cross-sectional or of short duration, which limits understanding of the long-term challenges. Eleven women [mean (SD) age 44.9(9.8)years; body mass index 40.3(4.0)kg m-2 ] participated in this longitudinal qualitative study, which included up to 20weeks of total diet replacement (825-853kcal day-1 ) and ongoing support for weight loss maintenance (WLM), to 2years. Semi-structured interviews were conducted at baseline and programme end, as well as at key intervals during the intervention. Questions examined five theoretical themes: motivation, self-regulation, habits, psychological resources and social/environmental influences. Data were coded and analysed in nvivo (https://qsrinternational.com/nvivo) using the framework method. In total, 64 interviews were completed (median, n=6 per participant). Mean (SD) weight loss was 15.7(9.6)kg (14.6% body weight) at 6months and 9.6(9.9)kg (8.8% body weight) at 2years. The prespecified theoretical model offered a useful framework to capture the variability of experiences. Negative aspects of obesity were strong motivations for weight loss and maintenance. Perceiving new routines as sustainable and developing a 'maintenance mindset' was characteristic of 'Maintainers', whereas meeting emotional needs at the expense of WLM goals during periods of stress and negative mood states was reported more often by 'Regainers'. Optimistic beliefs about maintaining weight losses appeared to interfere with barrier identification and coping planning for most participants. People tended to be very optimistic about WLM without acknowledging barriers and this may undermine longer-term outcomes. The potential for regain remained over time, mainly as a result of emotion-triggered eating to alleviate stress and negative feelings. More active self-regulation during these circumstances may improve WLM, and these situations represent important targets for intervention.

Characteristics of adults with overweight and obesity who have not attempted weight loss in the prior 12 months

ObjectiveTo determine weight-related characteristics of adults with overweight or obesity who had not attempted weight loss in the prior 12 months. MethodsAdults from the obesity cohort of the PORTAL clinical data research network were randomly selected to complete a survey in 2015. It included topics of experiences with health care providers, weight history, and health-promoting behaviors. ResultsA total of 2811 adults completed the survey, of whom 24% reported not attempting weight loss in the previous 12 months. Controlling for sociodemographic characteristics and body mass index, respondents who reported that their health care provider never talked about weight were more likely to not attempt weight loss in the previous 12 months compared with respondents who reported providers frequently brought up weight (OR: 0.45; 95% CI: 0.24, 0.66). Respondents who perceived themselves as normal weight or underweight were 4.22 times more likely (95% CI: 3.53, 5.05) to not attempt weight loss compared with respondents who perceived themselves as overweight. Respondents who reported that they never tried to lose at least 10 lbs, ate 0−2 servings of fruits and vegetables daily, or engaged in 0−29 min of physical activity weekly were less likely to attempt weight loss. ConclusionsReceiving advice on weight loss from health care providers to improve awareness of overweight and obesity status may be important factors for a person’s weight management. Provider discussions about weight may be a strategy to motivate weight loss attempts.

Providing Weight Loss Support to Patients Who Are Obese in Preparation for Colorectal Cancer Surgery to Reduce Surgical Site Infection Risk: A Mixed-methods Study

This mixed-methods study, using retrospective and prospective data, aimed to explore inhibitors and facilitators of preoperative weight loss in obese patients with colorectal cancer and the potential impact of preoperative weight loss support on SSIs. Patients with a body mass index (BMI) of ≥ 25 kg/m2 were eligible to participate in the weight loss support program. Patient demographic, history, surgical, and outcomes variables were abstracted from the records. Five (5) nurses who provided weight loss support participated in a focus group interview method to explore weight loss inhibitory and promotional factors. Descriptive statistics and qualitative analysis methods were used to examine the data. Twenty-six (26) patients participated in the program for a mean of 45.5 days (SD ± 25.3). Body weight decreased from 79.8 kg (SD ± 15.6) to 75.7 kg (SD ± 14.3), and BMI decreased from 30.4 kg/m² (SD ± 4.7) to 29.4 kg/m² (SD ± 5.0) (P < .05). The average weight loss percentage was 4.9% (SD ± 3.4). In 14 patients, the weight loss percentage was 5% or more. SSIs occurred in 5 of 26 patients (19.2%). Additionally, 4 of 26 patients (15.4%) who had 8.8% or more weight loss did not manifest SSIs. Previous weight loss before the preoperative surgery visits, lack of motivation for weight loss, and time and duration required for weight loss were identified as inhibitory factors, whereas history of successful weight loss experience, knowledge acquisition, family support, and reduced knee and lower back pain were identified as promotional factors for weight loss. Patients in this program lost weight prior to colorectal surgery. Research to further explore the safety and effects of preoperative weight loss in obese patients with colorectal cancer as well as inhibitory and promotional factors for participation and success is needed.

The Countervailing Effects of Weight Stigma on Weight-Loss Motivation and Perceived Capacity for Weight Control.

We hypothesized that exposure to weight stigma simultaneously increases motivation to lose or avoid gaining weight to avoid future stigma and decreases perceived capacity to do so, by heightening concerns about experiencing stigma and negative affect. Study 1 showed that more frequently experiencing weight-based discrimination was associated with greater concerns about being a victim of weight stigma, which predicted increased motivation to lose weight but decreased perceived capacity for weight control. Study 2 showed that participants randomly assigned to view a weight-stigmatizing (vs. control) message showed increased concerns about being a target of weight stigma, which indirectly increased motivation to lose weight and decreased state self-control. These, in turn, predicted increased willingness to engage in unhealthy weight-loss behaviors and decreased perceived capacity for weight control, respectively. Study 3 showed that increased motivation to avoid stigma and increased negative affect mediate these effects of exposure to weight stigma.

Instruments for evaluation of motivations for weight loss in individuals with overweight and obesity: A systematic review and narrative synthesis.

This systematic review aims to identify instruments used to assess motivations for weight loss in individuals with overweight and obesity from different age groups, such as children, adolescents, adults, and older adults. The virtual search was carried out using the PubMed, Scopus, LILACS, and ADOLEC databases, and by manual search. The following descriptors were used: questionnaire, scale, instrument, evaluation, motivation, motive, reason, “lose weight,” “losing weight,” “weight loss,” and slimming. Methodological quality was assessed according to the criteria of the COSMIN checklist. The search yielded 3,524 results, seven of which were included in the review. Six questionnaires assessing motivations for weight loss, which could be applied to various age groups, were identified. All the questionnaires presented items related to appearance and health as the main motivation for weight loss. In addition to these motivations, the questionnaires also included items related to improved sports performance, self-confidence, participation in important social events, family and social pressure, and fitting into different clothes. The most evaluated measurement properties in the studies were internal consistency, reliability, content validity, and construct validity. Regarding internal consistency, one was rated as excellent, one as fair, and three as poor. For reliability, two were rated as being of fair quality, and one as of poor quality. Two studies analyzed the content validity and the questionnaires were rated as being of poor methodological quality. Regarding structural validity, one was rated as excellent, another as fair, and another as poor quality. Only the Weight Loss Motivation Questionnaire presented excellent methodological quality for most of the analyzed criteria. There is a need to develop questionnaires that are of better methodological quality to assess motivations for weight loss. Instruments targeting the adolescent population should also be developed.

Persuasive System Design Principles and Behavior Change Techniques to Stimulate Motivation and Adherence in Electronic Health Interventions to Support Weight Loss Maintenance: Scoping Review.

BackgroundMaintaining weight after weight loss is a major health challenge, and eHealth (electronic health) solutions may be a way to meet this challenge. Application of behavior change techniques (BCTs) and persuasive system design (PSD) principles in eHealth development may contribute to the design of technologies that positively influence behavior and motivation to support the sustainable health behavior change needed.ObjectiveThis review aimed to identify BCTs and PSD principles applied in eHealth interventions to support weight loss and weight loss maintenance, as well as techniques and principles applied to stimulate motivation and adherence for long-term weight loss maintenance.MethodsA systematic literature search was conducted in PsycINFO, Ovid MEDLINE (including PubMed), EMBASE, Scopus, Web of Science, and AMED, from January 1, 2007 to June 30, 2018. Arksey and O’Malley’s scoping review methodology was applied. Publications on eHealth interventions were included if focusing on weight loss or weight loss maintenance, in combination with motivation or adherence and behavior change.ResultsThe search identified 317 publications, of which 45 met the inclusion criteria. Of the 45 publications, 11 (24%) focused on weight loss maintenance, and 34 (76%) focused on weight loss. Mobile phones were the most frequently used technology (28/45, 62%). Frequently used wearables were activity trackers (14/45, 31%), as well as other monitoring technologies such as wireless or digital scales (8/45, 18%). All included publications were anchored in behavior change theories. Feedback and monitoring and goals and planning were core behavior change technique clusters applied in the majority of included publications. Social support and associations through prompts and cues to support and maintain new habits were more frequently used in weight loss maintenance than weight loss interventions. In both types of interventions, frequently applied persuasive principles were self-monitoring, goal setting, and feedback. Tailoring, reminders, personalization, and rewards were additional principles frequently applied in weight loss maintenance interventions. Results did not reveal an ideal combination of techniques or principles to stimulate motivation, adherence, and weight loss maintenance. However, the most frequently mentioned individual techniques and principles applied to stimulate motivation were, personalization, simulation, praise, and feedback, whereas associations were frequently mentioned to stimulate adherence. eHealth interventions that found significant effects for weight loss maintenance all applied self-monitoring, feedback, goal setting, and shaping knowledge, combined with a human social support component to support healthy behaviors.ConclusionsTo our knowledge, this is the first review examining key BCTs and PSD principles applied in weight loss maintenance interventions compared with those of weight loss interventions. This review identified several techniques and principles applied to stimulate motivation and adherence. Future research should aim to examine which eHealth design combinations can be the most effective in support of long-term behavior change and weight loss maintenance.

Barriers and Facilitators to Weight and Lifestyle Management in Women with Polycystic Ovary Syndrome: General Practitioners' Perspectives.

Background: Weight and lifestyle management is advocated as the first-line treatment for polycystic ovary syndrome (PCOS) by evidence-based guidelines. Current literature describes both systems- and individual-related challenges that general practitioners (GPs) face when attempting to implement guideline recommendations for lifestyle management into clinical practice for the general population. The GPs’ perspective in relation to weight and lifestyle advice for PCOS has not been captured. Methods: Fifteen GPs were recruited to take part in semi-structured interviews. NVIVO software was used for qualitative analysis. Results: We report that GPs unanimously acknowledge the importance of weight and lifestyle management in PCOS. Practice was influenced by both systems-related and individual-related facilitators and barriers. Individual-related barriers include perceived lack of patient motivation for weight loss, time pressures, lack of financial reimbursement, and weight management being professionally unrewarding. System-related barriers include costs of accessing allied health professionals and unavailability of allied health professionals in certain locations. Individual-related facilitators include motivated patient subgroups such as those trying to get pregnant and specific communication techniques such as motivational interviewing. System-related facilitators include the GP’s role in chronic disease management. Conclusions: This study contributes to the understanding of barriers and facilitators that could be addressed to optimize weight and lifestyle management in women with PCOS in primary care.

Annals for Educators - 5 March 2019.

Annals for Educators - 5 March 2019.

Obesity.

The role of internists in evaluating obesity is to assess the burden of weight-related disease, mitigate secondary causes of weight gain (medications, sleep deprivation), and solicit patient motivation for weight loss. Internists should assess these factors and emphasize the importance of weight loss for the individual patient. All patients wishing to lose weight should be encouraged to monitor their diet and physical activity and should be referred to high-intensity behavioral programs. Some patients with obesity may also benefit from pharmacotherapy or bariatric surgery.