The transtheoretical model and motivational interviewing in the treatment of eating and weight disorders.

The transtheoretical stages of change model suffers from conceptual and empirical limitations, including problems of stage definition, measurement, and discreteness. Sequential transition across stages has not been established. The model lacks strong predictive utility, and there is little evidence that therapeutic interventions must be matched to stage to facilitate change. Initial tests applying the model to weight and eating disorders have been negative. Although the model is frequently associated with motivational interviewing (MI), no theory links the two. MI should be evaluated independently as a treatment for weight and eating disorders, to be used either alone or prior to treatments not explicitly addressing motivation. The conceptual compatibility and procedural overlap between cognitive behavioral therapy (CBT) and MI are analyzed.