Motivational Interviewing Improves Weight Loss in Women With Type 2 Diabetes

  1. Delia Smith West, PHD1,
  2. Vicki DiLillo, PHD2,
  3. Zoran Bursac, PHD1,
  4. Stacy A. Gore, PHD3 and
  5. Paul G. Greene, PHD1
  1. 1University of Arkansas for Medical Sciences College of Public Health, Little Rock, Arkansas
  2. 2Ohio Wesleyan University, Delaware, Ohio
  3. 3private practice, Nashville, Tennessee
  1. Address correspondence and reprint requests to Delia Smith West, PhD, UAMS College of Public Health, 4301 West Markham St., #820, Little Rock, AR 72205. E-mail: westdelia{at}uams.edu

Abstract

OBJECTIVE—We sought to determine whether adding motivational interviewing to a behavioral weight control program improves weight loss outcomes and glycemic control for overweight women with type 2 diabetes.

RESEARCH DESIGN AND METHODS—We conducted a randomized, controlled, clinical trial in which participants all received an 18-month, group-based behavioral obesity treatment and were randomized to individual sessions of motivational interviewing or attention control (total of five sessions) as an adjunct to the weight control program. Overweight women with type 2 diabetes treated by oral medications who could walk for exercise were eligible. Primary outcomes were weight and A1C, assessed at 0, 6, 12, and 18 months.

RESULTS—A total of 217 overweight women (38% African American) were randomized (93% retention rate). Women in motivational interviewing lost significantly more weight at 6 months (P = 0.01) and 18 months (P = 0.04). Increased weight losses with motivational interviewing were mediated by enhanced adherence to the behavioral weight control program. African-American women lost less weight than white women overall and appeared to have a diminished benefit from the addition of motivational interviewing. Significantly greater A1C reductions were observed in those undergoing motivational interviewing at 6 months (P = 0.02) but not at 18 months.

CONCLUSIONS—Motivational interviewing can be a beneficial adjunct to behavioral obesity treatment for women with type 2 diabetes, although the benefits may not be sustained among African-American women.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 2 March 2007. DOI: 10.2337/dc06-1966. Clinical trial reg. no. NCT00007800, clinicaltrials.gov.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted February 10, 2007.
    • Received September 20, 2006.
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  1. Diabetes Care vol. 30 no. 5 1081-1087
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