A Resource Guide of Motivational Techniques for Weight Loss

Abstract

Introduction

It is a well-known fact that weight loss reduces the risk of developing obesity-related disease.¹ The U.S. Preventative Services Task Force (USPSTF) recommends healthcare providers counsel and offer behavior modifications for all obese adults.² Best practice guidelines for treatment of obesity released by the USPSTF include intensive diet and behavioral therapy.² Motivational interviewing has been shown to improve patient adherence to treatment recommendations,³ as well as increase weight loss when applied as an adjunct to behavioral therapy.⁴ Other incentive-based approaches have been shown to improve weight loss.⁵

Patients identify various reasons they desire weight loss, but weight loss attempts are often only moderately successful in the short and long term.⁶ A 24-question Motivation for Weight Loss Scale my assist providers in tailoring interventions recommended for patients.⁷ By utilizing individualized motivational techniques, healthcare providers may improve weight loss among obese patients. This selection of papers and studies is compiled to assist the healthcare provider in identifying a patient's motivation for weight loss, and to suggest motivational techniques to improve weight loss.

Methods

A review of the literature using CINHAL and PubMed was conducted in September 2012. Topics used in the search included: incentives, motivation, motivational techniques, weight loss, and weight-reduction programs. The search was limited to the English language and peer-reviewed articles. The scope of the search was from 1988 to 2012. While this list includes many references pertaining to motivational techniques for weight loss, further literature searches related to specific techniques may supplement this list.

Bibliographic Findings

The bibliographic findings were selected for this article based on the contribution they provide in introducing healthcare providers to motivational interviewing (MI) and other possible motivational techniques for weight loss. Citations are categorized under the headings “comprehensive knowledge,” “motivational interviewing,” and “other incentives.”

Comprehensive knowledge

Brink, P. J., & Ferguson, K. (1998). The decision to lose weight. Western Journal of Nursing Research, 20(1), 84–102.

Chang, M., Nitzke, S., Guilford, E., Adair, C. H., & Hazard, D. L. (2008). Motivators and barriers to healthful eating and physical activity among low-income overweight and obese mothers. Journal of the American Dietetic Association, 108(6), 1023–1028.

Cox, M. E., Yancy, W. S. J., Coffman, C. J., Ostbye, T., Tulsky, J. A., Alexander, S. C., et al. (2011). Effects of counseling techniques on patients' weight-related attitudes and behaviors in a primary care clinic. Patient Education and Counseling, 85(3), 363–368.

Furia, A. C., Lee, R. E., Strother, M. L., & Huang, T. T. (2009). College students' motivation to achieve and maintain a healthy weight. American Journal of Health Behavior, 33(3), 256–263.

Hindle, L., & Carpenter, C. (2011). An exploration of the experiences and perceptions of people who have maintained weight loss. Journal of Human Nutrition & Dietetics, 24(4), 342–350.

Meyer, A. H., Weissen-Schelling, S., Munsch, S., & Margraf, J. (2010). Initial development and reliability of a motivation for weight loss scale. Obesity Facts, 3(3), 205–211.

Pollak, K. I., Coffman, C. J., Alexander, S. C., Manusov, J. R., Ostbye, T., Tulsky, J. A., et al. (2011). Predictors of weight loss communication in primary care encounters. Patient Education & Counseling, 85(3), 175–182.

Schelling, S., Munsch, S., Meyer, A. H., Newark, P., Biedert, E., & Margraf, J. (2009). Increasing the motivation for physical activity in obese patients. International Journal of Eating Disorders, 42(2), 130–138.

Webber, K. H., Tate, D. F., Ward, D. S., & Bowling, J. M. (2010). Motivation and its relationship to adherence to self-monitoring and weight loss in a 16-week internet behavioral weight loss intervention. Journal of Nutrition Education & Behavior, 42(3), 161–167.

Motivational interviewing

Armstrong, M. J., Mottershead, T. A., Ronksley, P. E., Sigal, R. J., Campbell, T. S., & Hemmelgarn, B. R. (2011). Motivational interviewing to improve weight loss in overweight and/or obese patients: A systematic review and meta-analysis of randomized controlled trials. Obesity reviews: An official journal of the International Association for the Study of Obesity, 12(9), 709–723.

Dilillo, V., & West, D. S. (2011). Motivational interviewing for weight loss. Psychiatric Clinics of North America, 34(4), 861–869.

Levensky, E., Forcehimes, A., O'Donohue, W., & Beitz, K. (2007). Motivational interviewing: An evidence-based approach to counseling helps patients follow treatment recommendations. American Journal of Nursing, 107(10), 50–58.

Walpole, B., Dettmer, E., Morrongiello, B., McCrindle, B., & Hamilton, J. (2011). Motivational interviewing as an intervention to increase adolescent self-efficacy and promote weight loss: Methodology and design. BMC Public Health, 11, 459.

West, D. S., DiLillo, V., Bursac, Z., Gore, S. A., & Greene, P. G. (2007). Motivational interviewing improves weight loss in women with type 2 diabetes. Diabetes Care, 30(5), 1081–1087.

Other incentives

Finkelstein, E. A., Linnan, L. A., Tate, D. F., & Birken, B. E. (2007). A pilot study testing the effect of different levels of financial incentives on weight loss among overweight employees. Journal of Occupational & Environmental Medicine, 49(9), 981–989.

Dolan, M. S., Weiss, L. A., Lewis, R. A., Pietrobelli, A., Heo, M., & Faith, M. S. (2006). “Take the stairs instead of the escalator”: Effect of environmental prompts on community stair use and implications for a national “Small Steps” campaign. Obesity reviews: An Official Journal of the International Association for the Study of Obesity, 7(1), 25–32.

McDoniel, S. O., Wolskee, P., & Shen, J. (2010). Treating obesity with a novel hand-held device, computer software program, and internet technology in primary care: The SMART motivational trial. Patient Education & Counseling, 79(2), 185–191.

Relton, C., Strong, M., & Li, J. (2011). The “Pounds for pounds” weight loss financial incentive scheme: An evaluation of a pilot in NHS eastern and coastal Kent. Journal of Public Health, 33(4), 536–542.

Svensson, M., & Lagerros, Y. T. (2010). Motivational technologies to promote weight loss-from internet to gadgets. Patient Education & Counseling, 79(3), 356–360.

Volpp, K. G., John, L. K., Troxel, A. B., Norton, L., Fassbender, J., & Loewenstein, G. (2008). Financial incentive-based approaches for weight loss: A randomized trial. Journal of the American Medical Association, 300(22), 2631–2637.

Conclusion

Best practice recommendations for patients with obesity include interventions for weight loss. Evidence suggests there are many reasons patients desire weight loss. However, there are no practice guidelines for motivational techniques to apply to practice. There is very little information available to guide providers in identifying patients' incentives for weight loss. Future research is needed linking different motivational techniques to patient motivators to increase adherence to treatment.

References

National Heart Lung, Blood Institute. National Heart, Lung and Blood Institute: clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: executive summary. Rockville, MD: National Institute of Health, 1998NIH Publication No. 98-4083.

U.S. Preventative Services Task Force, Screening for Obesity in Adults: Recommendations and Rationale. www.uspreventiveservicestaskforce.org/uspstf11/obeseadult/obesers.htm. 2012 September 19.

Levensky

, Forcehimes

, O'Donohue

, Beitz

. Motivational interviewing: an evidence-based approach to counseling helps patients follow treatment recommendations. Am J Nurs, 2007; 107:50–58.

West

, DiLillo

, Bursac

, Gore

, Greene

. Motivational interviewing improves weight loss in women with type 2 diabetes. Diabetes Care, 2007; 30:1081–1087.

Volpp

, John

, Troxel

, Norton

, Fassbender

, Loewenstein

. Financial incentive-based approaches for weight loss: a randomized trial. JAMA, 2008; 300:2631–2637.

Crawford

, Jeffery

, French

. Can anyone successfully control their weight? Findings of a three year community-based study of men and women. Int J Obes Relat Metab Disord, 2000; 24:1107–1110.

Meyer

, Weissen-Schelling

, Munsch

, Margraf

. Initial development and reliability of a motivation for weight loss scale. Obes Facts, 2010; 3:205–211.