Rebecca M. Puhl, PhD

Disclosures

February 25, 2011

In This Article

Motivating Patients to Lose Weight

With two thirds of Americans now overweight or obese, healthcare providers are often in the position of trying to help their patients manage their weight. Different clinical strategies have been proposed to facilitate weight loss and behavior changes in patients, but some strategies are more effective than others. For example, confrontational and lecturing styles of counseling are often unhelpful and frustrating for both patients and providers. In contrast, clinical approaches that focus more on reflective listening and support can increase patients' motivation and response to treatment. The hallmark approach that seeks to accomplish this is motivational interviewing.

Motivational Interviewing

Motivational interviewing (MI) is a client-centered, collaborative decision-making approach that involves providing nonjudgmental feedback to patients, allowing for patients' resistance to change and encouraging patients to develop their own arguments for engaging in health behavior change.[1] MI is a goal-directed approach that aims to lessen ambivalence about behavior change by emphasizing the discrepancy between personal goals and current health behaviors.[2] Using this style of counseling helps patients explore the disadvantages of not changing health behaviors vs the advantages and intentions of making positive lifestyle changes. However, a crucial piece of this approach is using an empathic listening style to enhance patients' self-efficacy, motivation, confidence, and personal control for behavior change.

Although MI was initially used to treat addictive behaviors, in recent years it has been applied to health behaviors related to diet, physical activity, and weight loss. Increasing research assessing the effectiveness of MI in these areas shows patient improvements in dietary behavior changes,[3] weight loss,[4,5,6,7] increased physical activity/fitness,[4,8,9] increased intake of fruit and vegetables,[9]and lower saturated fat intake.[10] Furthermore, this approach is inexpensive and can be used in brief appointments when patient-provider interactions are time-limited.

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