Weight loss using motivational interviewing in children/adolescents

Abstract

Background: Overweight/obesity is one of the fastest growing global health risks among all age groups. In particular, childhood overweight/obesity is a serious threat as it precedes adulthood obesity and increases the risk of premature morbidity and mortality making it a health, social and economic burden. This highlights the importance for the need of treatment interventions. The aim of this dissertation was to investigate the effectiveness of Motivational Interviewing in comparison to other methods in bringing about weight lose among overweight/obese children and adolescents. The research question: Among overweight/obese children and adolescents, is motivational interviewing effective in bringing about weight loss? PICO elements: Population (P): Overweigh/obese children and/or adolescents, Intervention (I): Motivational Interviewing (MI), Comparison (C): Alternative methods, Outcome (O): Weight loss. Method: A comprehensive and systematic literature search was carried out using a variety of different synonyms and phrases, a number of electronic databases and different search tools and limiters to filter and narrow down the search. Inclusion criteria applied were; overweight/obese children/adolescents aged from three to nineteen years, MI as the intervention, a non-MI intervention as the comparator, weight loss as an outcome measured as BMI/z-score/percentile. Exclusion criteria applied were; participants having conditions or on medication which affect weight, studies aimed at parents, MI used for prevention rather than treatment, studies having no control group or providing no care to control group. Four randomised controlled trials and one quasi-experimental study were identified. The RCT Critical Appraisal Skills Programme (CASP) tool was used to critically appraise the identified literature. Ethical issues were also considered. Results: The analysed findings demonstrate that MI might be more effective than alternative method in bringing about weight loss in overweight/obese children and adolescents. Conclusion: Study findings should be interpreted with caution and until more evidence becomes available a definitive conclusion on the effectiveness of MI on bringing about weight loss cannot be deduced. Implications and recommendations: Apart from the standard health education already provided in schools, MI can also be incorporated into the curriculum. Furthermore, the healthcare sector can look at setting up paediatric health clinics where behavioural counselling including MI is provided. Management should provide healthcare workers with guidelines and training on how to incorporate MI into their care. Nonetheless, further research to overcome outlined methodological limitations to better determine the effectiveness of MI interventions, is required.