Motivation For Weight Loss Research Articles

Screening and brief intervention for obesity in primary care: a parallel, two-arm, randomised trial

SummaryBackgroundObesity is a common cause of non-communicable disease. Guidelines recommend that physicians screen and offer brief advice to motivate weight loss through referral to behavioural weight loss programmes. However, physicians rarely intervene and no trials have been done on the subject. We did this trial to establish whether physician brief intervention is acceptable and effective for reducing bodyweight in patients with obesity.MethodsIn this parallel, two-arm, randomised trial, patients who consulted 137 primary care physicians in England were screened for obesity. Individuals could be enrolled if they were aged at least 18 years, had a body-mass index of at least 30 kg/m2 (or at least 25 kg/m2 if of Asian ethnicity), and had a raised body fat percentage. At the end of the consultation, the physician randomly assigned participants (1:1) to one of two 30 s interventions. Randomisation was done via preprepared randomisation cards labelled with a code representing the allocation, which were placed in opaque sealed envelopes and given to physicians to open at the time of treatment assignment. In the active intervention, the physician offered referral to a weight management group (12 sessions of 1 h each, once per week) and, if the referral was accepted, the physician ensured the patient made an appointment and offered follow-up. In the control intervention, the physician advised the patient that their health would benefit from weight loss. The primary outcome was weight change at 12 months in the intention-to-treat population, which was assessed blinded to treatment allocation. We also assessed asked patients' about their feelings on discussing their weight when they have visited their general practitioner for other reasons. Given the nature of the intervention, we did not anticipate any adverse events in the usual sense, so safety outcomes were not assessed. This trial is registered with the ISRCTN Registry, number ISRCTN26563137.FindingsBetween June 4, 2013, and Dec 23, 2014, we screened 8403 patients, of whom 2728 (32%) were obese. Of these obese patients, 2256 (83%) agreed to participate and 1882 were eligible, enrolled, and included in the intention-to-treat analysis, with 940 individuals in the support group and 942 individuals in the advice group. 722 (77%) individuals assigned to the support intervention agreed to attend the weight management group and 379 (40%) of these individuals attended, compared with 82 (9%) participants who were allocated the advice intervention. In the entire study population, mean weight change at 12 months was 2·43 kg with the support intervention and 1·04 kg with the advice intervention, giving an adjusted difference of 1·43 kg (95% CI 0·89–1·97). The reactions of the patients to the general practitioners' brief interventions did not differ significantly between the study groups in terms of appropriateness (adjusted odds ratio 0·89, 95% CI 0·75–1·07, p=0·21) or helpfulness (1·05, 0·89–1·26, p=0·54); overall, four (<1%) patients thought their intervention was inappropriate and unhelpful and 1530 (81%) patients thought it was appropriate and helpful.InterpretationA behaviourally-informed, very brief, physician-delivered opportunistic intervention is acceptable to patients and an effective way to reduce population mean weight.FundingThe UK National Prevention Research Initiative.

Motivation for Gluten-Free Diet Adherence among Adults with and without a Clinically Diagnosed Gluten-Related Illness

Background and Purpose: Historically used as the sole treatment for celiac disease, there has been a substantial rise in popularity of the gluten-free diet (GFD) as both a diet plan and alternative form of medicine in the United States (US). Approximately 1% of the US population suffers from celiac disease, but various reports show 30% to 80% of adults have an interest in, or are currently adhering to, a GFD. This study aimed to understand this disproportion by exploring GFD adherence motivations, in addition to medical diagnoses, within a population of gluten-free followers. Methods. An anonymous, internetbased survey was administered to assess GFD motivations and adherence within the general population (n=99). Results. Of those currently following or who had previously followed a GFD, medical diagnosis was reported by only 28.6% as motivation for GFD adherence, with 60.7% reporting general health motivations, 25.0% reporting weight loss motivations, and 21.4% reporting curiosity. Conclusion. This study supports previous research suggesting that adherence to a GFD may occur for reasons outside of a medical diagnosis. Public health educators should inform individuals about risks and misconceptions associated with GFDs when implementing healthy eating programs for adults without medically diagnosed digestive conditions.

Does Reduction Mammaplasty Play a Role in Weight-Loss Motivation and Quality of Life Improvement in Symptomatic Macromastia Patients?

Does Reduction Mammaplasty Play a Role in Weight-Loss Motivation and Quality of Life Improvement in Symptomatic Macromastia Patients?

The effect of communicating the genetic risk of cardiometabolic disorders on motivation and actual engagement in preventative lifestyle modification and clinical outcome: a systematic review and meta-analysis of randomised controlled trials.

Genetic risk prediction of chronic conditions including obesity, diabetes and CVD currently has limited predictive power but its potential to engage healthy behaviour change has been of immense research interest. We aimed to understand whether the latter is indeed true by conducting a systematic review and meta-analysis investigating whether genetic risk communication affects motivation and actual behaviour change towards preventative lifestyle modification. We included all randomised controlled trials (RCT) since 2003 investigating the impact of genetic risk communication on health behaviour to prevent cardiometabolic disease, without restrictions on age, duration of intervention or language. We conducted random-effects meta-analyses for perceived motivation for behaviour change and clinical changes (weight loss) and a narrative analysis for other outcomes. Within the thirteen studies reviewed, five were vignette studies (hypothetical RCT) and seven were clinical RCT. There was no consistent effect of genetic risk on actual motivation for weight loss, perceived motivation for dietary change (control v. genetic risk group standardised mean difference (smd) -0·15; 95 % CI -1·03, 0·73, P=0·74) or actual change in dietary behaviour. Similar results were observed for actual weight loss (control v. high genetic risk SMD 0·29 kg; 95 % CI -0·74, 1·31, P=0·58). This review found no clear or consistent evidence that genetic risk communication alone either raises motivation or translates into actual change in dietary intake or physical activity to reduce the risk of cardiometabolic disorders in adults. Of thirteen studies, eight were at high or unclear risk of bias. Additional larger-scale, high-quality clinical RCT are warranted.

The consumption of dietary supplement which contains plant extracts affects superoxide dismutase activity in healthy adults

The consumption of dietary supplement which contains plant extracts affects superoxide dismutase activity in healthy adults

Weight loss practices among newly enrolling clients in a commercial weightloss program in Ghana.

In Ghana, obesity is showing a rising trend and there are weight loss initiatives being practised by individuals. However, the levels of commitment to such programs and the reasons for discontinuing have not been assessed. The objectives of this study were to investigate the weight loss practices of participants and reasons for quitting chosen weight loss programs. This was a cross-sectional study involving 50 subjects conveniently selected from people who were enrolling into a commercial weight loss program. A questionnaire was used to collect data on past weight loss practices and reasons for abandoning chosen programs. Data analysis was conducted using simple frequency and descriptive tests of the Excel software. More than half of the subjects (66%) had undertaken a weight loss practice before enrolment in study. Of these, 88.5% abandoned the strategy before the achievement of their desired weight goal. The three common programs that were practised were internet based diets (67.9%), commercial weight loss shakes (42.9%) and exercises (28.6%). Reasons given for abandoning programs included lack of sustainability (50%), lack of determination on the part of the client (15%), boredom with program (10%), not achieving desired results (10%), safety concerns (10%), and getting pregnant (5%). The findings suggest that future weight loss programs can be effective and have reduced attrition rates if they are designed to achieve sustainable dietary and other lifestyle changes, as well as boost motivation for weight loss.

Motivation for Weight Loss

This pilot study focuses on the impact of types of initial diet and exercise motivation on weight loss in a group of urban black women who attended a 12-week clinic-based weight loss program. Seventeen program participants completed the Treatment Self-Regulation Questionnaire at the initial session. Weekly weights and pre-post blood pressure and body mass index values were obtained. Autonomous motivation for a healthy diet (β = .77, P = .002) and initial weight (β = .02, P = .001) contributed significantly to the regression model. Predictors of average weekly weight loss can help to tailor interventions. Positive features of the program are discussed.

Higher Motivation for Weight Loss in African American than Caucasian Rural Patients with Hypertension and/or Diabetes.

To examine the relationship between race/ethnicity and motivation for weight loss and motivation for exercise among patients with chronic disease. Cross-sectional. Our study took place within a network of federally qualified health centers (FQHCs) in the rural southern United States. 463 active FQHC patients with diabetes and/or hypertension identifying as African American, White Hispanic, or non-Hispanic White participated in our study. Primary outcomes were assessed using standardized measures of motivation for a) weight loss; and b) hypertension per the Transtheoretical Model. Multivariate logistic regression revealed that, when controlling for age, sex, education status, employment status, poverty, comorbidity, and weight status, there were no significant differences in motivation for exercise among the different racial/ethnic groups (P=.361). However, when controlling for the same factors, there was a significant difference in motivation for weight loss, with African American participants more than twice as likely as non-Hispanic White participants to be motivated to lose weight (ORADJ = 2.430, P=.002). Our study suggests that, among rural patients with obesity-related chronic disease, there is a significant variation in motivation to lose weight between racial/ethnic groups. This underscores the importance of culturally tailoring interventions and in considering motivation for change when promoting weight loss behaviors. Additional implications for intervention development and delivery are discussed.

Ethnic Identity Attachment and Motivation for Weight Loss and Exercise Among Rural, Overweight, African-American Women.

Rural and minority women are disproportionately impacted by the obesity epidemic; however, little research has studied the intersection of these disparity groups. The purpose of this study was to examine the influence of racial identity on motivation for weight loss and exercise among rural, African-American women with an obesity-linked chronic disease. A total of 154 African-American women were recruited from the patient population of a Federally Qualified Health Center in the rural South to complete a questionnaire battery including the Multigroup Ethnic Identity Measure and separate assessments of motivation for weight loss and exercise. Multivariate analyses, controlling for age, education status, insurance status, and body mass index revealed that attachment to ethnic identity was predictive of motivation for exercise but not for weight loss. Our findings suggest that attachment to ethnic identity may be an important factor in motivation for change among African-American women, particularly with respect to exercise, with direct implications for the development of culturally and geographically tailored weight loss interventions.

Behaviors and motivations for weight loss in children and adolescents: Weight Loss Behaviors and Motivations in Children

Behaviors and motivations for weight loss in children and adolescents: Weight Loss Behaviors and Motivations in Children

Behaviors and motivations for weight loss in children and adolescents.

To examine the association between weight loss behaviors and motivations for weight loss in children and adolescents and the association of weight status with these behaviors and motivations in a nationally representative sample. Data from the National Health and Nutrition Examination Survey (NHANES) was examined, focusing on children in the United States aged 8-15 years, in repeated cross-sections from 2005 to 2011. Half of participants (N = 6,117) reported attempting to lose weight, and children with obesity attempted to lose weight more frequently (76%) than children who were a healthy weight (15%). Children reported attempting to lose weight by both healthy and unhealthy means: "exercising" (92%), "eating less sweets or fatty foods" (84%), "skipping meals" (35%), and "starving" (18%). The motivation to be better at sports was more likely to be associated with attempting weight loss through healthy behaviors, whereas children motivated by teasing were more likely to engage in unhealthy behaviors. Motivations for losing weight differed by weight status. Many children and adolescents attempt to lose weight, using either or both healthy and unhealthy behaviors, and behaviors differed based on motivations for weight loss. Future research should examine how physicians, parents, and teachers can inspire healthy behavior changes.

A qualitative study exploring why adults with intellectual disabilities and obesity want to lose weight and views of their carers

BackgroundObesity is more prevalent in adults with intellectual disabilities (ID) compared to the general population. Motivations for weight loss may influence engagement with weight management programmes and have only been studied in adults without ID. Aims: To determine reasons given by adults with ID and obesity for seeking weight loss and whether these reasons differ from those of their carers.MethodsPrior to a multi-component weight management intervention, participants were asked “why do you want to lose weight?” Carers were asked their views and these were compared to the answers given by the adult with ID. Responses were themed. The Fisher’s Exact analysis was used to test for any relationship between reasons for seeking weight loss and participants’ level of ID, age, gender and BMI.ResultsEighteen men and 32 women; age 41.6 SD 14.6 years; BMI 40.8 SD 7.5 kg/m2; Level ID Mild (28 %), Moderate (42 %), Severe (22 %), Profound (8 %). Eleven were unable to respond. Six themes emerged; Health; Fitness / Activity / Mobility; Appearance / Clothes; Emotional / Happiness; For Others; Miscellaneous. The most frequent reason given overall and by women was “appearance.” Carers cited “health” most frequently and “appearance” least, rarely agreeing with participants. “Health” was given as a reason more from older adults and those with milder ID. No statistically significant associations were found between reasons for seeking weight loss and BMI age, gender or level of ID but the differing views of adults with ID and their carers were clear.ConclusionsViews of adults with obesity and mild or moderate ID can be collected. The opposing views of adults and their carers may affect motivation for weight loss.

The Importance of Weight Change Experiences for Performance of Diabetes Self-Care: A Patient-Centered Approach to Evaluating Clinical Outcomes in Type 2 Diabetes.

IntroductionThe aim of this study was to examine the influence of weight change experiences over time on motivation to perform diabetes self-care behaviors using data from a study of canagliflozin (an agent that inhibits sodium glucose co-transporter 2) versus glimepiride in dual therapy with metformin and background diet/exercise.MethodsWeight and motivation for performing healthy behaviors were collected at baseline and over time. The motivation questionnaire enabled categorization into two groups: those performing or not performing health behaviors. Four distinct patterns of weight change were determined: losing weight, gaining weight, and two patterns for fluctuating weight. The relationships between these patterns and motivation for weight loss, following a diet, and exercise were examined using logistic regression models.ResultsOf 1182 subjects, more than half were already performing behaviors to lose weight, diet, and exercise at baseline. Among those who were not, 52% (246/474) started taking action to lose weight after baseline, 54% (241/448) started following a diet, and 42% (232/556) started exercising. Weight change patterns were significantly related to performance of healthy behaviors at follow-up (week 36). Compared to the weight gain pattern, those who experienced a continuous weight loss pattern from baseline to week 36 were 2.2 (95% confidence interval 1.49, 3.37) times more likely to perform the healthy behaviors. Baseline behavior and confidence were also predictive of performing healthy behaviors.ConclusionThe current work highlights the importance of weight change patterns for performance of diabetes self-care. Tracking weight patterns over time, assessing confidence for performance of healthy behaviors, and being aware of the relationship between weight changes and diabetes self-care behaviors are viable, concrete ways to practice patient-centered care.FundingJanssen Global Services, LLC.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-015-0145-8) contains supplementary material, which is available to authorized users.

Abstract P122: Fidelity to Motivational Interviewing and Weight Loss in Young Adults: Cellphone Intervention for You (CITY) Trial

Background: Weight loss interventions for obese young adults may reduce serious health complications later in life. Motivational Interviewing (MI) is part of behavioral weight loss intervention. Effective delivery of MI is variable; therefore, we assessed whether fidelity to MI was associated with change in weight and dietary pattern in overweight/obese young adults. Methods: The Cellphone Intervention for You (CITY) trial was a 24-month behavioral intervention that randomized 365 overweight/obese (BMI &gt;25 kg/m2) young adults (aged 18-35 years) to a weight loss program delivered by either mobile technology or interventionist-led personal coaching (PC) phone calls, or to a control condition. PC participants attended a series of 6-weekly group meetings immediately followed by monthly audio-recorded phone calls conducted by an interventionist trained to deliver weight loss counseling using MI. We coded the first monthly PC phone call using Motivational Interviewing Treatment Integrity Version (MITI) 3.1.1 and evaluated the impact of MITI summary scores on changes in weight and Healthy Eating Index (HEI) at 6 months. Results: Our study population was comprised of 74 participants with available audio-recordings. There were 73% (N=54) women and 49% minorities with a mean age of 29 ± 4 years and a mean BMI of 34.7 ± 7.3 kg/m2. Mean change in weight 6 months post-randomization was -3.1 ± 5.3 kg. Mean change in HEI was 3.3 ± 4.7. Mean MITI summary scores for global spirit, percent complex reflections and reflection-to-question ratio were 3.9 ± 0.8, 0.6 ± 0.3, and 0.5 ± 0.2, respectively. None were predictive of weight change 6 months post-randomization (table 1). Percent complex reflection was predictive of HEI, with a counterintuitive negative relationship (table 1). Conclusions: In our study population of overweight/obese young adults, greater fidelity to MI in the first coaching call was not associated with greater weight change or improved HEI. Additional research is needed to further explore the impact of MI on behavior.

Investigating motivations for weight loss and benefits of attending a commercial weight management organisation post-natally

Previous reports have indicated that women feel pressure from celebrity culture andwider society to lose weight swiftly after having a baby (Netmums and The Royal College of Midwives, 2010). The aim of this study was to investigate women’s motivations to lose weight postnatally, weight loss achieved and impact on selfesteem. A survey of women attending Slimming World (SW) who had given birth in the last 2 years was hosted on SWweb-site during September 2013. The survey used quantitative and qualitative questions to determine motivation and lifestyle behaviours and asked for self-reported weight and height. 1015 women responded. The majority of participants (n = 533, 52.5%) had been members for <3months; mean joining BMI was 33.3 kg/m2 (SD 5.85) and mean BMI at time of survey 30.5 kg/m2 (SD 5.86). The main reasons for wanting to lose weight were ‘to improve how I feel about my body size and shape’ (22%), ‘to improve my confidence’ (19%) and ‘to lose weight I gained during pregnancy’ (17%). A combined 3% citedmedia/ social pressure as a reason to lose weight and 31% agreed to feeling under social/media pressure to be an ideal weight post-natally. A range of weight gains in pregnancywere reported, themost common being between 1 and 2 stone. 71% (n = 611) of those who already had children reported having retained weight from a previous pregnancy. 82% said retaining weight postnatally affected their selfesteem. After losing weight with SW, 38% were lighter than their pre-pregnancy weight and 78.6% expressed improvements in selfesteem since joining SW. Social/media pressure plays a minimal role in a woman’s decision to lose weight post-natally. Motivation is more personal. Attendance at SW resulted in weight loss and improved self-esteem in post-natal women.

The role of nurse support within an Internet-delivered weight management intervention: A qualitative study

This qualitative study explored patients’ experiences of nurse support for an Internet-delivered weight management intervention. Eighteen patients who had received either basic or regular nurse support (three or seven contacts, respectively) for the Internet intervention were interviewed. The data were analysed using thematic analysis. The findings suggest that more regular support for Internet interventions may have the potential to inhibit the development of autonomous motivation for weight loss, which might lead to problems in sustaining losses after support ends. Further research is now needed to confirm whether motivation is influenced by frequency of nurse support in Internet interventions in order to inform the development of optimal support which promotes sustained weight loss.

Misperceptions of weight status among adolescents: sociodemographic and behavioral correlates.

ObjectiveAccurate perceptions of weight status are important motivational triggers for weight loss among overweight or obese individuals, yet weight misperception is prevalent. To identify and characterize individuals holding misperceptions around their weight status, it may be informative for clinicians to assess self-reported body mass index (BMI) classification (ie, underweight, normal, overweight, obese) in addition to clinical weight measurement.MethodsSelf-reported weight classification data from the 2007 Current Visit Information – Child and Adolescent Survey collected at Mayo Clinic in Rochester, MN, were compared with measured clinical height and weight for 2,993 adolescents.ResultsWhile, overall, 74.2% of adolescents accurately reported their weight status, females, younger adolescents, and proxy (vs self) reporters were more accurate. Controlling for demographic and behavioral characteristics, the higher an individual’s BMI percentile, the less likely there was agreement between self-report and measured BMI percentile. Those with high BMI who misperceive their weight status were less likely than accurate perceivers to attempt weight loss.ConclusionAdolescents’ and proxies’ misperception of weight status increases with BMI percentile. Obtaining an adolescent’s self-perceived weight status in addition to measured height and weight offers clinicians valuable baseline information to discuss motivation for weight loss.

The influence of cognitive factors in the treatment of obesity: Lessons from the QUOVADIS study

Weight-loss maintenance remains a problematic issue in lifestyle modification programmes, but a small percentage of individuals are able to maintain a significant long-term weight loss. This means cognitive mechanisms may effectively contrast the biological pressures to regain weight arising from an obesiogenic environment. Aims of this review were to summarizes and synthesizes the data on the cognitive factors associated with program attrition, weight loss and weight maintenance derived from the QUOVADIS (QUality of life in Obesity: eVAluation and DIsease Surveillance), an observational study on quality of life in 1944 obese patients seeking treatment in 25 medical centres in Italy, and discuss its results in light of other literature. The data obtained suggest that some cognitive factors are associated with treatment discontinuation (namely higher weight-loss expectations, appearance-based primary motivation for weight loss, and unsatisfactory progress), while others with the amount of weight lost (i.e., increased dietary restraint and reduced disinhibition) or with long-term weight loss maintenance in patients who interrupted the treatment (i.e., satisfaction with results achieved, confidence in being able to lose weight without professional help). All these findings have important clinical implications.

Weight Loss Motivations: A Latent Class Analysis Approach

To identify subgroups of adults with respect to weight loss motivations and assess factors associated with subgroup membership. A cross-sectional survey among 414 overweight/ obese employees in 12 Massachusetts high schools was conducted. Latent class analysis (LCA) defined distinct weight loss motivation classes. Multinomial logistic regression assessed participant characteristics with class membership. Three classes emerged: improving health; improving health and looking/feeling better; and improving health, looking/feeling, better and improving personal/social life. Compared to class 1, class 2 was more likely to be female and younger and class 3 was more likely to be female, younger, have children at home, and perceive themselves as very over-weight. Findings can inform targeted weight loss interventions.

Moderators of quality of life among overweight adolescents. Influence of body mass index, sociodemographics, behavioral, motivational and clinical variables.

Overweight is an extra burden for adolescent development and triggers serious physical and psychosocial problems. Overweight in adolescence has been consistently associated with poorer psychosocial and emotional wellbeing. This study aims to evaluate moderators of quality of life in adolescents with excess weight. The sample consists of 94 adolescents who are attending a specialized Pediatric Obesity Clinic, 46 boys (48.94%), median age of 14.17 years (SD = 1.51). Weight-related quality of life was assessed with the 27-item measure, developed by Kolotkin et al. (IWQOL-K: Impact of Weight on Quality of Life-Kids). Statistical analysis was performed using nonparametric tests (Spearman correlation, Mann–Whitney U test and Kruskal–Wallis test). Body Mass Index (BMI) z -score correlated negatively with quality of life in terms of physical comfort, social life and overall quality of life index. Gender, weight loss motivation, perception of body image, presence of binge eating episodes and mother’s education level were found to work as quality of life moderators. These results underscore the importance of routinely assessing quality of life when treating overweight adolescents. Intervention programs should be designed not only to tailor the individual adolescent health needs but also take into account those moderators that have been identified.