None listed
Conditions
Brief summary
Aims: The primary aim of the present study is to improve the maintenance of weight loss in obese adults. To do so, it will combine the most promising approaches suggested by previous research, namely, (i) motivational enhancement therapy (MET) and (ii) instructing the support partners of obese patients in the strategies of MET. Given the prevalence of obesity, any feasible solution will need to limit the need for patients to have intensive, ongoing healthcare. By enhancing the self-motivation of patients to control their weight over time and improving the quality of social support patients have for weight control, this double-faceted approach aims to improve the maintenance of weight loss while minimising the need of patients for ongoing healthcare service utilisation. Method: The current study entails a two-arm randomised controlled trial in which obese patients will receive a one-year cognitive-behavioural weight control intervention augmented by MET; this intervention will be implemented with and without the inclusion of support partners. A total of 150 patients from Canberra and Sydney will participate in the study (75 in each of the two treatment conditions), yielding an estimated power of 80%. The inclusion criteria include 18-70 years of age, a body mass index between 30-60, and the availability of one support partner to attend sessions. Patients will be excluded if they have psychiatric or medical conditions that would preclude full participation in the study, are currently receiving treatment for obesity or treatments known to affect weight, or are pregnant. A comprehensive battery of medical, behavioral and psychological measures will be administered at baseline, post-treatment and at a one-year follow-up to evaluate the effectiveness of the various interventions. Treatment will consist of 26 sessions for patients and, in the conditions targeting social support, 10 sessions for support partners over a 12-month period. All treatments will be manual-based and treatment fidelity checks and quality control will be undertaken.
Interventions
Patients and Support Partners:
Obese patients will attend 90-minute group sessions conducted by a clinical psychologist. The one-year period of intervention will be comprised of 8 weekly, 16 fortnightly, and 2 monthly sessions. The intervention will entail a combination of cognitive behaviour therapy (CBT) and motivational enhancement therapy (MET) that has been manualised. In the CBT component, patients will be provided with information regarding the dietary and physical activity requirements
Patients and Support Partners: Obese patients will attend 90-minute group sessions conducted by a clinical psychologist. The one-year period of intervention will be comprised of 8 weekly, 16 fortnightly, and 2 monthly sessions. The intervention will entail a combination of cognitive behaviour therapy (CBT) and motivational enhancement therapy (MET) that has been manualised. In the CBT component, patients will be provided with information regarding the dietary and physical activity requirements for weight loss and maintenance, and will be taught a range of behavioural and cognitive strategies to assist with weight control (e.g., self monitoring, stimulus control, goal setting, challenging negative self-talk, pleasant activity scheduling, problem-solving, relaxation training, and relapse prevention strategies). The MET component seeks to enhance patients’ intrinsic motivation to control their weight through targeting decisional balance (so that the advantages/pros of weight control come to outweigh the disadvantages/cons) and self efficacy (so that patients are confident that they can effectively control their weight over time). MET components include education regarding the nature of behavioural change (e.g., the stages of precontemplation, contemplation, preparation, action, and maintenance), examining each patient’s pros and cons of weight control (e.g., exploring valued goals and how the patient’s current weight undermines the attainment of these goals), developing alternative means of fulfilling the needs met through overeating or being overweight (e.g., learning stress management strategies if overeating is a means of coping with stress), and building confidence that change is possible (e.g., identifying each patient’s strengths and available supports). The program for the Support Partners of obese patients will be based on programs instructing support partners in motivational strategies for patients with substance dependence and eating disorders. Support Partners will attend 90-minute group sessions conducted by a clinical psychologist. The one-year period of intervention will be comprised of 10 sessions. These groups will be run separately to those for the patients. Similar to the CBT+MET intervention for patients, Support Partners will be provided with information regarding the nature of behavioural change, assisted to examine the patient’s pros and cons of weight control, encouraged to generate alternative methods the patient can use for fulfilling the needs met through overeating or being overweight and developing a plan to introduce these methods to the patient, assisted to understand strategies for increasing the patient’s confidence that change is possible, and encouraged to adopt a communication style that is consistent with MET (e.g., being empathic and avoiding arguing or attempting to control the patient).
Sponsors
Australian National University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
The inclusion criteria include: 18-70 years of age; a body mass index (BMI) between 30-60; and one support partner who will be available to attend sessions.
Exclusion criteria
The exlusion criteria include: psychiatric conditions (i.e., current psychosis, major depressive disorder, drug or alcohol abuse/dependence, or mental retardation) or severe medical conditions (i.e., significant hepatic or renal dysfunction and significant cardiovascular disease such as heart failure) that would preclude full participation in the study; current treatment for obesity including bariatric surgery, current treatments known to affect eating or weight (e.g., medications); pregnancy; and insufficient English to understand the treatment content.
Outcome results
None listed