A randomized controlled trial comparing scalable weight loss treatments in primary care

Rachel D Barnes, Marney A White, Steve Martino, Carlos M Grilo, Rachel D Barnes, Marney A White, Steve Martino, Carlos M Grilo

Abstract

Objective: Primary-care (PC) settings may be an opportune place to deliver obesity interventions. Scalable interventions utilizing motivational interviewing (MI), supported by Internet resources, may overcome obstacles to effective obesity treatment dissemination. This study was a randomized controlled trial testing two Web-supported interventions, motivational interviewing (MIC) and nutrition psychoeducation (NPC), an attention-control intervention, in comparison with usual care (UC).

Methods: Eighty-nine overweight/obese patients, with and without binge eating disorder (BED), were randomly assigned to MIC, NPC, or UC for 3 months in PC. Patients were assessed independently at post-treatment and at 3-month follow-up.

Results: Weight, triglyceride levels, and depression scores decreased significantly in NPC when compared to UC but not MIC; UC and MIC did not differ significantly. Weight loss results maintained at 3-month follow-up: approximately 25% MIC and NPC patients achieved at least 5% weight loss which did not differ by BED status. Fidelity ratings were high and treatment adherence was associated with weight loss.

Conclusions: This is the first randomized controlled trial in PC testing MI for weight loss to include an attention-control intervention (NPC). NPC, but not MIC, showed a consistent pattern of superior benefits relative to UC. BED status was not associated, but treatment adherence was associated, with weight loss outcomes.

Conflict of interest statement

Conflicts of Interest: RDB, MAW, and SM have no conflicts of interest.

CMG reports no relevant conflicts of interest but has received consultant fees from Shire, honoraria from American Psychological Association and American Academy of CME, and book royalties from Guilford Press and Taylor and Francis for academic books.

© 2014 The Obesity Society.

Figures

Figure 1. Treatment recruitment and retention consort
Figure 1. Treatment recruitment and retention consort
Figure 2. Intent-to-treat percent weight loss
Figure 2. Intent-to-treat percent weight loss
Note. MIC= Motivational Interviewing and Internet Condition. NPC= Nutrition Psychoeducation and Internet Condition. UC=Usual Care.
Figure 3. Percent of participants reaching at…
Figure 3. Percent of participants reaching at least 5% loss of initial weight
Note. MIC= Motivational Interviewing and Internet Condition. NPC= Nutrition Psychoeducation and Internet Condition. UC=Usual Care.

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Source: PubMed

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