May 18, 2007

Psychological Technique Helps Women With Diabetes Lose Weight

Tara Dairman

A new study of overweight women with Type 2 diabetes showed that the addition of a technique called “motivational interviewing” to a weight-loss program helped women lose more weight and keep it off more successfully. The study was published in the May 2007 issue of the journal Diabetes Care.

The trial, which took place over 18 months and included 217 overweight women with Type 2 diabetes, randomly divided participants into two groups. Both groups took part in a group-based behavioral obesity treatment program, which consisted of regular group meetings and recommendations of a reduced-calorie, reduced-fat diet and increased physical activity. Other behavioral and diabetes-specific topics were also addressed in the meetings. In addition, participants kept diaries of their food intake and physical activity.

The women randomly assigned to the "motivational interview" group also took part in five 45-minute sessions with a psychologist over the course of the study. These sessions employed a "client-centered" technique in which the psychologist asked open-ended questions and provided nonjudgmental responses to help the client explore her own reasons and motivations for making behavioral changes (such as entering the weight-loss program). The technique, according to the study, focused on "emphasizing personal choice for action, affirming self-confidence in ability to change, and supporting perceived importance of behavioral change." The other group of women (the control, or placebo, group) received the same number of individual health education sessions, focusing on women's health topics of the participant's choosing.

While both groups lost weight, the women in the motivational-interview group ended up losing about twice as much weight as the control group by the end of the 18-month study (about 8 pounds for the interview group vs. about 4 pounds for the control group). What's more, after an initial weight-loss period of six months, members of the motivational interview group fared better at maintaining their weight loss than members of the control group. Women in both groups also experienced significant reductions in their HbA1c levels at 6 months and 12 months (with the women in the motivational interview group experiencing greater reductions), but by the end of the study HbA1c values were no longer significantly lower than they had been at the beginning of the study.

The researchers concluded that motivational interviewing sessions had a significant benefit for weight loss and blood glucose control in overweight women with Type 2 diabetes. The study's results support the idea that occasional sessions with a mental health professional, which can allow a person to explore her motivations for making lifestyle changes, can play an important role in a person's diabetes-care regimen and weight-loss plan.

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