Rachel D Barnes1,2, Valentina Ivezaj3, Steve Martino3,4, Brian P Pittman3, Manuel Paris3, Carlos M Grilo3,5. 1. Division of General Internal Medicine, University of Minnesota Medical School, MMC 741 420 Delaware Street SE, Minneapolis, MN, 55455, USA. rdbarnes@umn.edu. 2. Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA. rdbarnes@umn.edu. 3. Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA. 4. VA Connecticut Healthcare System, West Haven, CT, USA. 5. Department of Psychology, Yale University, New Haven, CT, USA.
Abstract
PURPOSE: Motivational interviewing (MI) weight-loss interventions have garnered much attention, particularly in primary care. Few studies, however, have examined long-term outcomes of MI for weight loss in primary care. This study sought to examine the longer-term outcomes of a combination approach comprising MI and nutrition psychoeducation (MINP) with a publically available web-support component (i.e., livestrong.com). METHODS: Thirty-one adults with overweight/obesity were enrolled in a 3-month MINP treatment delivered in primary care by medical assistants. Weight, blood pressure, and depression (beck depression inventory) were assessed at baseline and 1-year following treatment cessation (i.e., 15 months total). RESULTS: Participants' average BMI was significantly lower 12-months following treatment. Approximately one-third of participants (34.8%) maintained 5% or more weight loss. Participants also experienced significant decreases in diastolic blood pressure, resting heart rate, and depression symptoms, but not systolic blood pressure or waist circumference. CONCLUSION: The scalable (2.5 h total) MINP intervention delivered in primary care by medical assistants resulted in significant weight (medium effect size) and psychological improvements 12 months later. These findings complement previous RCT findings that MI or nutrition psychoeducation interventions, delivered separately, resulted in small weight loss effects after 12 months, with 5% and 17% of participants, respectively, maintaining 5% weight loss. It remains unclear, however, if implementing MI in primary care for weight loss is cost effective beyond providing nutrition psychoeducation alone. CLINICAL TRIAL REGISTRATION: The clinical trial registration number is NCT02578199. LEVEL OF EVIDENCE: IV, uncontrolled trial.
PURPOSE: Motivational interviewing (MI) weight-loss interventions have garnered much attention, particularly in primary care. Few studies, however, have examined long-term outcomes of MI for weight loss in primary care. This study sought to examine the longer-term outcomes of a combination approach comprising MI and nutrition psychoeducation (MINP) with a publically available web-support component (i.e., livestrong.com). METHODS: Thirty-one adults with overweight/obesity were enrolled in a 3-month MINP treatment delivered in primary care by medical assistants. Weight, blood pressure, and depression (beck depression inventory) were assessed at baseline and 1-year following treatment cessation (i.e., 15 months total). RESULTS: Participants' average BMI was significantly lower 12-months following treatment. Approximately one-third of participants (34.8%) maintained 5% or more weight loss. Participants also experienced significant decreases in diastolic blood pressure, resting heart rate, and depression symptoms, but not systolic blood pressure or waist circumference. CONCLUSION: The scalable (2.5 h total) MINP intervention delivered in primary care by medical assistants resulted in significant weight (medium effect size) and psychological improvements 12 months later. These findings complement previous RCT findings that MI or nutrition psychoeducation interventions, delivered separately, resulted in small weight loss effects after 12 months, with 5% and 17% of participants, respectively, maintaining 5% weight loss. It remains unclear, however, if implementing MI in primary care for weight loss is cost effective beyond providing nutrition psychoeducation alone. CLINICAL TRIAL REGISTRATION: The clinical trial registration number is NCT02578199. LEVEL OF EVIDENCE: IV, uncontrolled trial.
Authors: Rachel D Barnes; Valentina Ivezaj; Steve Martino; Brian P Pittman; Manuel Paris; Carlos M Grilo Journal: J Psychosom Res Date: 2017-11-28 Impact factor: 3.006
Authors: Pamela D Martin; Gareth R Dutton; Paula C Rhode; Ronald L Horswell; Donna H Ryan; Phillip J Brantley Journal: Obesity (Silver Spring) Date: 2008-09-11 Impact factor: 5.002
Authors: Youfa Wang; May A Beydoun; Lan Liang; Benjamin Caballero; Shiriki K Kumanyika Journal: Obesity (Silver Spring) Date: 2008-07-24 Impact factor: 5.002
Authors: Rachel D Barnes; Valentina Ivezaj; Steve Martino; Brian P Pittman; Carlos M Grilo Journal: Obesity (Silver Spring) Date: 2017-10-31 Impact factor: 5.002
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