Research Article
The Effect of Motivational Interviewing on Women with Overweight and Obesity Before Conception

https://doi.org/10.1016/j.jneb.2020.04.219Get rights and content

Abstract

Objective

To investigate the efficacy of motivational interviewing (MI) to elicit change in eating and physical activity behaviors in women with overweight and obesity before conception.

Design

A randomized controlled trial was conducted. The participants were randomly divided into intervention and comparison groups. Data were gathered using the Three-Factor Eating Questionnaire Revised 18-item version (TFEQ-R18), International Physical Activity Questionnaire (IPAQ), and Stages of Change checklist.

Setting

Primary health centers of Tabriz, Iran.

Participants

The participants were 70 women with overweight or obesity, aged 18–35 years, who were referred for preconception care.

Intervention(s)

The intervention group received 6 MI sessions, and the comparison group received routine preconception care.

Main Outcome Measure(s)

Variables of primary outcomes were eating behavior measures and physical activity levels 8 weeks after intervention.

Analysis

Independent t test, ANCOVA, Fisher exact test, Mann-Whitney U test, and Wilcoxon test were used.

Results

The MI had a positive effect on physical activity in the moderate and vigorous levels in the intervention group (P = .01, P = .02, respectively). After the intervention, the mean score of cognitive restraint in the intervention group was higher than in the comparison group (adjusted mean difference, 16.9; 95% CI, 10.8 to 23.0; P < .001), whereas there were no significant differences between the 2 groups in terms of emotional and uncontrolled eating (P = .33 and P = .25, respectively).

Conclusions and Implications

The MI had a positive effect on physical activity and eating behavior change, except for uncontrolled and emotional eating. Future studies to examine differences between overweight and women with obesity and within other populations is warranted.

Section snippets

INTRODUCTION

The rate of obesity has doubled in women of reproductive age (15–49 years) over the past 25 years, with an obesity rate of 20% at the beginning of pregnancy.1 Obesity in pregnancy is associated with an increase in maternal and fetal complications, such as increased risks of hypertensive disorders, gestational diabetes, miscarriage, intrauterine death, prolonged labor, dystocia, and delivery by cesarean section.2, 3, 4, 5 The probability of fetal malformations, including neural tube defects,

Study Design and Participants

This randomized controlled trial was conducted with 70 women with overweight or obesity who were referred to the primary health centers of Tabriz, Iran, for their preconception care. The inclusion criteria were women before conception with the age range of 18–35 years, women with overweight (body mass index [BMI], 25–29.9) and obesity grade I (BMI, 30–35),15 and having at least elementary education. The exclusion criteria included having any known physical (cardiovascular, thyroid disorders,

RESULTS

The study was conducted with 70 women from June to August in 2018, and follow-up assessments continued up to October 2018 (Figure). There was no loss to follow-up during the study. There was no significant difference between groups in terms of sociodemographic characteristics (Table 2).

Before the intervention, there was no significant difference between groups in terms of cognitive restraint and uncontrolled and emotional eating (P > .05). After the intervention, no significant difference was

DISCUSSION

The research question was to investigate the efficacy of MI to elicit change in eating and physical activity behaviors in women with overweight and obesity before conception. The results indicated a significant increase in the mean score of cognitive restraint in the MI group compared with the comparison group after intervention. Despite an increased score in emotional eating and a decreased score in uncontrolled eating after MI-based counseling, there was no statistically significant

IMPLICATIONS FOR RESEARCH AND PRACTICE

The MI-based counseling had a positive effect on physical activity and eating behavior change, except for uncontrolled and emotional eating in women with overweight or obesity. Additional research is warranted to determine the behavior differences between women with overweight or obesity before conception. Moreover, a similar study design in other populations with longer follow-ups (6 months and 1 year) is recommended.

ACKNOWLEDGMENTS

This study is derived from a master's thesis in midwifery. The authors acknowledge the research deputy of Tabriz University of Medical Sciences. The authors would like to show their gratitude to those women who cooperated in this study.

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  • Conflict of Interest Disclosure: The authors have not stated any conflicts of interest.

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