Motivational Interviewing to Treat Adolescents With Obesity: A Meta-analysis

Abstract

Successful treatment approaches are needed for obesity in adolescents. Motivational interviewing (MI), a counseling approach designed to enhance behavior change, shows promise in promoting healthy lifestyle changes. OBJECTIVE: Conduct a systematic review of MI for treating overweight and obesity in adolescents and meta-analysis of its effects on anthropometric and cardiometabolic outcomes.

Response to Vorland et al's Letter to the Editor about “Impact of motivational interviewing on outcomes of an adolescent obesity treatment: Results from the MI Values randomized controlled pilot trial”

“…MI is widely promoted for use within obesity treatments, yet empirical support remains limited. 5 The current study does not support its impact on improving BMI z-scores.…”

“…Thus, research to understand potential strategies to optimize these outcomes is needed. MI is widely promoted for use within obesity treatments, yet empirical support remains limited . The current study does not support its impact on improving BMI z ‐scores.…”

Motivating Children and Adolescents in Obesity Treatment

“…[44][45][46][47] A recent meta-analysis on the effectiveness of MI to treat adolescents with obesity yielded a nonsignificant overall reduction in BMI z-score and other cardiometabolic outcomes, such as insulin and triglycerides. 47 However, some promising outcomes were reported related to increased health-related behaviors and quality of life. 46,47 A meta-analysis on children with obesity treated with MI also presented mixed results regarding treatment outcomes.…”

“…47 However, some promising outcomes were reported related to increased health-related behaviors and quality of life. 46,47 A meta-analysis on children with obesity treated with MI also presented mixed results regarding treatment outcomes. 45 Three trials included in the review demonstrated that MI intervention is more effective than usual care in decreasing BMI, while three other trials showed null effects regarding BMI.…”

The Heterogeneity of MI Interventions Studies for Treatment of Obesity

“…They conclude "MI alone does not seem effective for treating overweight and obesity in adolescents." 1 The authors appropriately note several mitigating factors that temper their conclusions including the relatively low dose of the active interventions in which MI was used (the core interventions were generally far less than the US Preventive Services Task Force guideline of 26 contact hours 2 ), as well as the lack of information on MI fidelity to allow comparison of outcomes based on practitioner competency. In addition to these concerns, we propose a few other issues that may impact the validity of their analyses and corresponding conclusions.…”