Examining motivational interviewing plus nutrition psychoeducation for weight loss in primary care

摘要

Abstract Objective Our previous randomized controlled trial found that nutrition psychoeducation (NP), an attention-control condition, produced statistically significantly more weight loss than usual care (UC), whereas motivational interviewing (MI) did not. NP, MI, and UC resulted in medium-large, medium, and negligible effects on weight loss, respectively. To examine whether weight loss could be further improved by combining MI and NP, the current study evaluated the scalable combination (MINP) with accessible web-based materials. Methods 31 adults with overweight/obesity, with and without binge-eating disorder (BED), were enrolled in the 3-month MINP treatment in primary care. Participants were assessed at baseline, post, and 3-month follow-up. Mixed-model analyses examined MINP effects over time and the prognostic significance of BED. Results Mixed-model analyses revealed that percentage weight loss was statistically significant at post and 3-month follow-up; d’=0.59 and 0.53, respectively. BED status did not predict or moderate weight loss. Twenty-one percent (6 of 28) and 26% (7 of 27) of participants attained 5% weight loss by post-treatment and 3-month follow-up, respectively. Participants with BED had statistically significantly greater improvements in disordered eating and depression (in addition to binge-eating reductions) compared to those without BED. Conclusion MINP resulted in weight and psychological improvements at post-treatment and through 3-months after treatment completion. There did not appear to be additional benefits to combining basic nutrition information with MI when compared to the previous randomized controlled trial testing nutrition psychoeducation alone. Clinical Trial Registration: NCT02578199 . Highlights ? Brief intervention resulted in statistically significant weight loss in primary care. ? Approximately 25% of participants (7/27) reached 5% weight loss by 3-month follow-up. ? Weight loss was not superior to previously published nutrition psychoeducation-only. ? More research is needed to understand the utility of MI for weight loss in primary care.