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Motivational Interviewing for Weight Management Among Women: a Meta-Analysis and Systematic Review of RCTs

Abstract

Background

Motivational interviewing (MI) is a communication skill set used by clinicians to help facilitate adherence to numerous health behaviors. Currently, MI’s evidence supports its use among adults in various realms; however, clarity is needed regarding weight management among females. The purpose of this systematic review and meta-analysis is to synthesize the literature examining the use of MI and its impact on anthropometric measures among adult females.

Method

The authors conducted a modified Cochrane method of systematic search and review in several relevant databases to explore and report evidence and gaps in the literature for MI in weight management among females in addition to meta-analyses for weight and BMI. Criteria for retention included randomized controlled trials with open inclusion of studies with varied settings, methods, interventionists, target behaviors, and outcomes.

Results

Of the 3289 references initially identified, 10 intervention arms met the criteria across review tiers. Seven of 10 intervention groups reported significant anthropometric changes compared with a control group, as well as significant changes in non-anthropometric outcomes related to weight management. Using a random-effects model, the effect size of MI on reduction in body weight (kg) was 0.19 (95% CI − 0.13, 0.26; p < 0.01), and the effect size of MI on reduction in BMI was 0.35 (95% CI 0.12, 0.58; p < 0.01).

Conclusions

Results suggest that MI interventions are useful for weight management among females. Future studies would enhance the current base of literature by utilizing advanced anthropometric outcomes, including sex-specific results, and including more diverse and larger sample sizes.

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References

  1. Collaborators GO. Health effects of overweight and obesity in 195 countries over 25 years. NEW ENGL J MED. 2017;377(1):13–27.

    Article  Google Scholar 

  2. Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5· 24 million UK adults. Lancet. 2014;384(9945):755–765.

  3. National Heart, Lung, Blood Institute, National Institute of Diabetes, Digestive, & Kidney Diseases (US). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report (No. 98). 1998.

  4. NHLBI Panel OE. Managing overweight and obesity in adults: systematic evidence review. 2013.

  5. Kasen S, Cohen P, Chen H, Must A. Obesity and psychopathology in women: a three decade prospective study. Int J Obes. 2008;32(3):558.

    CAS  Article  Google Scholar 

  6. Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67(3):220–9.

    PubMed  Article  Google Scholar 

  7. Roberts RE, Deleger S, Strawbridge WJ, Kaplan GA. Prospective association between obesity and depression: evidence from the Alameda County Study. Int J Obes. 2003;27(4):514.

    CAS  Article  Google Scholar 

  8. Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity: payer-and service-specific estimates: amid calls for health reform, real cost savings are more likely to be achieved through reducing obesity and related risk factors. Health Aff. 2009;28(Suppl1):w822–31.

    Article  Google Scholar 

  9. Trogdon J, Finkelstein EA, Hylands T, Dellea P, Kamal-Bahl S. Indirect costs of obesity: a review of the current literature. Obes Rev. 2008;9(5):489–500.

    CAS  PubMed  Article  Google Scholar 

  10. World Health Organization “Obesity and overweight.” https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight#In_2016_39%_of_adults_tripled_between_1975_and_2016

  11. Garawin F, Devries K, Thorogood N, Uauy R. Global differences between women and men in the prevalence of obesity: is there an association with gender inequality? Eur J Clin Nutr. 2014;68(10):1101–6.

    Article  Google Scholar 

  12. Mayo Clinic. Exercise: 7 benefits of regular physical activity. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389. Accessed December 14, 2019.

  13. Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ. 2006;174(6):801–9.

    PubMed  PubMed Central  Article  Google Scholar 

  14. Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1· 9 million participants. Lancet Glob Health. 2018;6(10):1077–86.

    Article  Google Scholar 

  15. Ding D. Surveillance of global physical activity: progress, evidence, and future directions. Lancet Glob Health. 2018;6(10):1046–7.

    Article  Google Scholar 

  16. Sabinsky MS, Toft U, Raben A, Holm L. Overweight men’s motivations and perceived barriers towards weight loss. Eur J Clin Nutr. 2007;61(4):526–31.

    CAS  PubMed  Article  Google Scholar 

  17. Sharifi N, Mahdavi R, Ebrahimi-Mameghani M. Perceived barriers to weight loss programs for overweight or obese women. HPP. 2013;3(1):11.

    PubMed  PubMed Central  Google Scholar 

  18. Solbrig L, Jones R, Kavanagh D, May J, Parkin T, Andrade J. People trying to lose weight dislike calorie counting apps and want motivational support to help them achieve their goals. Internet Interv. 2017;7:23–31.

    PubMed  PubMed Central  Article  Google Scholar 

  19. West DS, Gorin AA, Subak LL, et al. A motivation-focused weight loss maintenance program is an effective alternative to a skill-based approach. Int J Obes. 2011;35(2):259.

    CAS  Article  Google Scholar 

  20. Elfhag K, Rössner S. Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. OBES REV. 2005;6(1):67–85.

    CAS  PubMed  Article  Google Scholar 

  21. Silva MN, Markland D, Carraca EV, et al. Exercise autonomous motivation predicts 3-yr weight loss in women. Med Sci Sports Exerc. 2011;43(4):728–37.

    PubMed  Article  Google Scholar 

  22. Teixeira PJ, Going SB, Sardinha LB, Lohman T. A review of psychosocial pre-treatment predictors of weight control. OBES REV. 2005;6(1):43–65.

    CAS  PubMed  Article  Google Scholar 

  23. Miller WR, Rollnick S. Motivational interviewing: helping people change: Guilford press; 2012.

  24. Burke BL, Arkowitz H, Menchola M. The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J Consult Clin Psychol. 2003;71(5):843.

    PubMed  Article  Google Scholar 

  25. Lundahl BW, Kunz C, Brownell C, Tollefson D, Burke BL. A meta-analysis of motivational interviewing: twenty-five years of empirical studies. Res Soc Work Pract. 2010;20(2):137–60.

    Article  Google Scholar 

  26. Rubak S, Sandbæk A, Lauritzen T, Christensen B. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract. 2005;55(513):305–12.

    PubMed  PubMed Central  Google Scholar 

  27. Armstrong M, Mottershead T, Ronksley P, Sigal R, Campbell T, Hemmelgarn B. Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta-analysis of randomized controlled trials. OBES REV. 2011;12(9):709–23.

    CAS  PubMed  Google Scholar 

  28. Barnes RD, Ivezaj V. A systematic review of motivational interviewing for weight loss among adults in primary care. OBES REV. 2015;16(4):304–18.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  29. Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions (Vol. 4): John Wiley & Sons; 2011.

  30. Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36(3):1–48.

    Article  Google Scholar 

  31. Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  32. Duval SJ, Tweedie RL. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000a;56(2):455–63.

    CAS  Article  PubMed  Google Scholar 

  33. Duval SJ, Tweedie RL. A nonparametric “trim and fill” method of accounting for publication bias in meta-analysis. J Am Stat Assoc. 2000b;95(449):89–98.

    Google Scholar 

  34. Duval S. The trim and fill method. Publication bias in meta-analysis: prevention, assessment and adjustments. 2005;127–144.

  35. Cohen J. A coefficient of agreement for nominal scales. EDUC PSYCHOL MEAS. 1960;20(1):37–46.

    Article  Google Scholar 

  36. McHugh ML. Interrater reliability: the kappa statistic. Biochem Med. 2012;22(3):276–82.

    Article  Google Scholar 

  37. Befort CA, Nollen N, Ellerbeck EF, Sullivan DK, Thomas JL, Ahluwalia JS. Motivational interviewing fails to improve outcomes of a behavioral weight loss program for obese African American women: a pilot randomized trial. J Behav Med. 2008;31(5):367.

    PubMed  Article  Google Scholar 

  38. Mirkarimi SK, Kabir MJ. Comparing the effect of motivational interviewing and standard nutrition education on promoting adherence to weight loss program in obese and overweight women: a randomized clinical trial. JMUMS. 2015;25(124):200–8.

    Google Scholar 

  39. Mirkarimi K, Kabir MJ, Honarvar MR, Ozouni-Davaji RB, Eri M. Effect of motivational interviewing on weight efficacy lifestyle among women with overweight and obesity: a randomized controlled trial. Iran J Med Sci. 2017;42(2):187.

    PubMed  PubMed Central  Google Scholar 

  40. Reinhardt JA, van der Ploeg HP, Grzegrzulka R, Timperley JG. Implementing lifestyle change through phone-based motivational interviewing in rural-based women with previous gestational diabetes mellitus. Health Promot J Austr. 2012;23(1):5–9.

    PubMed  Article  Google Scholar 

  41. Saffari M, Pakpour AH, Mohammadi-Zeidi I, Samadi M, Chen H. Long-term effect of motivational interviewing on dietary intake and weight loss in Iranian obese/overweight women. HPP. 2014;4(2):206.

    PubMed  PubMed Central  Google Scholar 

  42. Smith DE, Heckemeyer CM, Kratt PP, Mason DA. Motivational interviewing to improve adherence to a behavioral weight-control program for older obese women with NIDDM: a pilot study. Diabetes Care. 1997;20(1):52–4.

    CAS  PubMed  Article  Google Scholar 

  43. Webber KH, Gabriele JM, Tate DF, Dignan MB. The effect of a motivational intervention on weight loss is moderated by level of baseline controlled motivation. IJBNPA. 2010;7(1):4.

    PubMed  PubMed Central  Google Scholar 

  44. West DS, DiLillo V, Bursac Z, Gore SA, Greene PG. Motivational interviewing improves weight loss in women with type 2 diabetes. Diabetes Care. 2007;30(5):1081–7.

    PubMed  Article  Google Scholar 

  45. Williams L, Hollis JL, Collins CE, Morgan P. Can a relatively low-intensity intervention by health professionals prevent weight gain in mid-age women? 12-month outcomes of the 40-Something randomised controlled trial. Nutr Diabetes. 2014;4(5):e116.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  46. Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences.

  47. Behav Res Methods. 2007;39(2):175–91.

  48. Svendsen OL, Haarbo J, Hassager C, Christiansen C. Accuracy of measurements of body composition by dual-energy x-ray absorptiometry in vivo. Am J Clin Nutr. 1993;57(5):605–8.

    CAS  PubMed  Article  Google Scholar 

  49. Visser M, Fuerst T, Lang T, et al. Validity of fan-beam dual-energy X-ray absorptiometry for measuring fat-free mass and leg muscle mass. J Appl Physiol. 1999;87(4):1513–20.

    CAS  PubMed  Article  Google Scholar 

  50. Apodaca TR, Longabaugh R. Mechanisms of change in motivational interviewing: a review and preliminary evaluation of the evidence. Addiction. 2009;104(5):705–15.

    PubMed  PubMed Central  Article  Google Scholar 

  51. Copeland L, McNamara R, Kelson M, Simpson S. Mechanisms of change within motivational interviewing in relation to health behaviors outcomes: a systematic review. Patient Educ Couns. 2015;98(4):401–11.

    PubMed  Article  Google Scholar 

  52. Miller WR, Rollnick S. Meeting in the middle: motivational interviewing and self-determination theory. IJBNPA. 2012;9(1):25.

    PubMed  PubMed Central  Google Scholar 

  53. Vansteenkiste M, Sheldon KM. There’s nothing more practical than a good theory: Integrating motivational interviewing and self-determination theory. Br J Soc Clin Psychol. 2006;45(1):63–82.

    Article  Google Scholar 

  54. Markland D, Ryan RM, Tobin VJ, Rollnick S. Motivational interviewing and self–determination theory. J Soc Clin Psychol. 2005;24(6):811–31.

    Article  Google Scholar 

  55. Deci EL, Ryan RM. Self-determination theory: a macrotheory of human motivation, development, and health. Can Psychol. 2008;49(3):182.

    Article  Google Scholar 

  56. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68.

    CAS  PubMed  Article  Google Scholar 

  57. Gourlan M, Sarrazin P, Trouilloud D. Motivational interviewing as a way to promote physical activity in obese adolescents: a randomised-controlled trial using self-determination theory as an explanatory framework. Psychol Health. 2013;28(11):1265–86.

    PubMed  Article  Google Scholar 

  58. Friederichs SA, Oenema A, Bolman C, Lechner L. Long term effects of self-determination theory and motivational interviewing in a web-based physical activity intervention: randomized controlled trial. IJBNPA. 2015;12(1):101.

    PubMed  PubMed Central  Google Scholar 

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Correspondence to Kameron B. Suire.

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Suire, K.B., Kavookjian, J., Feiss, R. et al. Motivational Interviewing for Weight Management Among Women: a Meta-Analysis and Systematic Review of RCTs. Int.J. Behav. Med. 28, 403–416 (2021). https://doi.org/10.1007/s12529-020-09934-0

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Keywords

  • Motivational interviewing
  • Anthropometric outcomes
  • Females
  • Lifestyle behaviors
  • Nutrition
  • Physical activity