October 27, 2014
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Nutrition psychoeducation outperforms usual care for weight loss in primary care

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In a primary care treatment setting the use of nutrition psychoeducation appears to be superior to usual care in achieving weight loss for overweight and obese patients, according to recent findings.

In the study, researchers assessed 89 obese and overweight patients with and without binge eating disorder (BED), who were undergoing primary care treatment at an urban, university-based medical health care center. The patients were aged ≥18 years and have a BMI of ≥25. Patients were evaluated at baseline, week 12 and 3-month follow-up.

Patients were randomized to one of three treatment groups: motivational interviewing (MCI; n=30), nutrition psychoeducation (NPC; n=29) or usual care (n=30). MIC is a five-session, 12-week intervention that uses personal interviewing techniques to encourage motivation for weight loss-related behavior change. NPC is a five-session pscyhoeducation program focused on recommended nutritional intake and weight loss/calorie goals. Usual care consisted of patients continuing to work with their primary care doctors to lose weight. They were asked to regrain from starting any new weight loss interventions until the 3 month follow-up.

The researchers found significant decreases in body weight, triglyceride levels and depression in the NPC group vs. usual care, but no significant differences were found between MIC and usual care. At the 3 month follow-up, roughly 25% of MIC and NPC patients attained at least 5% weight loss and this result did not vary based on BED status. Both interventions had high fidelity and adherence ratings. While the MIC group had slightly higher treatment adherence than the NPC group, it did not equal more weight loss.

According to the researchers, it is not clear why NPC performed better than MIC in this study and they noted that additional study is needed.

“Additional areas of future research include developing more extensive, and most importantly, free or low cost and accessible web-based weight loss resources available to [primary care] settings that can serve as an adjunct to [primary care] clinician support,” the researchers wrote. “Continuing to examine these and other elements of addressing weight loss in [primary care] may further improve outcomes.”

Disclosure: One researcher reports financial ties with the American Academy of CME, the American Psychological Association, the Guilford Press, Shire and Taylor and Francis. The study was funded in part by NIH.