Motivational interviewing improves weight loss in women with type 2 diabetes

UAMS College of Public Health, 4301 West Markham St., #820, Little Rock, AR 72205, USA.
Diabetes care (Impact Factor: 8.57). 06/2007; 30(5):1081-7. DOI: 10.2337/dc06-1966
Source: PubMed

ABSTRACT We sought to determine whether adding motivational interviewing to a behavioral weight control program improves weight loss outcomes and glycemic control for overweight women with type 2 diabetes.
We conducted a randomized, controlled, clinical trial in which participants all received an 18-month, group-based behavioral obesity treatment and were randomized to individual sessions of motivational interviewing or attention control (total of five sessions) as an adjunct to the weight control program. Overweight women with type 2 diabetes treated by oral medications who could walk for exercise were eligible. Primary outcomes were weight and A1C, assessed at 0, 6, 12, and 18 months.
A total of 217 overweight women (38% African American) were randomized (93% retention rate). Women in motivational interviewing lost significantly more weight at 6 months (P = 0.01) and 18 months (P = 0.04). Increased weight losses with motivational interviewing were mediated by enhanced adherence to the behavioral weight control program. African-American women lost less weight than white women overall and appeared to have a diminished benefit from the addition of motivational interviewing. Significantly greater A1C reductions were observed in those undergoing motivational interviewing at 6 months (P = 0.02) but not at 18 months.
Motivational interviewing can be a beneficial adjunct to behavioral obesity treatment for women with type 2 diabetes, although the benefits may not be sustained among African-American women.

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    • "All of the studies recruited overweight and obese individuals although their health status varied. Participants in the TONE trial [44] and study by Banks-Wallace [70] were hypertensive, participants in the WLM trial [56] were hypertensive and/or dyslipidemic, the DPP trial [11] participants presented with impaired glucose tolerance, West et al. [14] and McNabb et al. [69] recruited type 2 diabetics, and Djuric et al. [62] recruited breast cancer survivors. "
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    ABSTRACT: We performed a systematic review of the behavioral lifestyle intervention trials conducted in the United States published between 1990 and 2011 that included a maintenance phase of at least six months, to identify intervention features that promote weight loss maintenance in African American women. Seventeen studies met the inclusion criteria. Generally, African American women lost less weight during the intensive weight loss phase and maintained a lower % of their weight loss compared to Caucasian women. The majority of studies failed to describe the specific strategies used in the delivery of the maintenance intervention, adherence to those strategies, and did not incorporate a maintenance phase process evaluation making it difficult to identify intervention characteristics associated with better weight loss maintenance. However, the inclusion of cultural adaptations, particularly in studies with a mixed ethnicity/race sample, resulted in less % weight regain for African American women. Studies with a formal maintenance intervention and weight management as the primary intervention focus reported more positive weight maintenance outcomes for African American women. Nonetheless, our results present both the difficulty in weight loss and maintenance experienced by African American women in behavioral lifestyle interventions.
    Journal of obesity 04/2013; 2013:437369. DOI:10.1155/2013/437369
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    • "Dietician, psychologist and exercise physiologist. West et al. [40] 39% African American, 61% Caucasian Motivational interviewing. To determine whether adding motivational interviewing to a behavioral weight control program improves weight loss outcomes and glycemic control. "
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    Patient Education and Counseling 04/2013; 92(2). DOI:10.1016/j.pec.2013.03.007 · 2.60 Impact Factor
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    • "When implementing MI, providers encourage individuals to set the agenda, discuss challenges to behavior change, and selfselect behavior change goals (Rollnick, Miller & Butler, 2007). The effectiveness of motivational interviewing has been demonstrated in a wide range of interventions, including interventions to promote nutrition and physical activity (Resnicow et al., 2002; West et al., 2007). "
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    Journal of the American Academy of Nurse Practitioners 12/2010; 22(12):684-93. DOI:10.1111/j.1745-7599.2010.00562.x · 0.87 Impact Factor
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