Preliminary examination of metabolic syndrome response to motivational interviewing for weight loss as compared to an attentional control and usual care in primary care for individuals with and without binge-eating disorder

Abstract

Motivational interviewing (MI) treatment for weight loss is being studied in primary care. The effect of such interventions on metabolic syndrome or binge eating disorder (BED; DSM-5 criteria), both highly related to excess weight, has not been examined. This study conducted secondary analyses from a randomized controlled trial to test the impact of MI for weight loss in primary care on metabolic syndrome. 74 adult participants with overweight/obesity recruited through primary care were randomized to 12 weeks of either MI, an attentional control, or usual care. Participants completed measurements for metabolic syndrome at pre- and post-treatment. There were no statistically significant differences in metabolic syndrome rates at pre-, X2(2)=0.16, p = 0.921, or post-, X2(2)=0.852, p = 0.653 treatment. The rates in metabolic syndrome, however, decreased for MI (10%) and attentional control (13.8%) participants, but not for usual care. At baseline, metabolic syndrome rates did not differ significantly between participants with BED or without BED across treatments. At post-treatment, participants with BED were significantly more likely to meet criteria for metabolic syndrome than participants without BED, X2(1)=5.145, p = 0.023, phi =.273. Across treatments, metabolic syndrome remitted for almost a quarter of participants without BED (23.1%) but for 0% of those with BED. These preliminary results are based on a small sample and should be interpreted with caution, but they are the first to suggest that relatively low intensity MI weight loss interventions in primary care may decrease metabolic syndrome rates but not for individuals with BED.

Back to Basics? No Weight Loss from Motivational Interviewing Compared to Nutrition Psychoeducation at One‐Year Follow‐Up

“…In our study, participants randomized to NPC (attention‐control condition) maintained, on average, almost a 2% initial body weight loss after receiving a total of only 2 hours and 20 minutes of nutrition psychoeducation. Similarly, 1 year after receiving treatment, 4 of 23 (17.4%) NPC participants maintained a 5% or more weight loss, a goal associated with attenuating weight‐related health consequences ; only 1 of 21 (4.8%) individuals receiving MI maintained a 5% weight loss. The latter finding is similar to that reported by Martin and colleagues , who reported 7% of participants maintained or achieved a 5% or more weight loss 12 months following MI treatment.…”

“…Overall, the literature has been mixed on whether BED impacts weight loss trials . Perhaps individuals with BED recruited from primary care for the current trial differ from those recruited through specialty clinics for weight loss treatment .…”

Promoting Successful Cognitive Aging: A Ten-Year Update

“…Although the effect sizes measured were very small, the intervention was also associated with a 24% to address several behaviors and conditions, such as smoking cessation [541] and alcohol use disorder [542]. In patient populations with or at risk for chronic health conditions, the incorporation of MI principles into behavior change counseling has effectively increased physical activity [543], weight loss [544,545], and management of cardiovascular risk factors [546,547]. MI has been shown to be effective even in brief or time-limited interventions [542,548].…”

Comparing physical activity in individuals with overweight/obesity with and without binge eating disorder

“…Binge-eating disorder (BED) is defined as consuming unusually large quantities of food in a relatively brief period of time, coupled with a subjective sense of loss of control over eating, but without frequent compensatory behaviours (1). BED is associated with excess weight (2)(3)(4), possible greater difficulty losing weight (5,6) and worse health outcomes (7)(8)(9)(10), even after controlling for body mass index (BMI) (10). One important potential mechanism for the weight-related and health-related discrepancies may be physical activity.…”