Article | Published:

Clinical research

Functional imagery training versus motivational interviewing for weight loss: a randomised controlled trial of brief individual interventions for overweight and obesity

International Journal of Obesity (2018) | Download Citation

Abstract

Objective

Functional Imagery Training (FIT) is a new brief motivational intervention based on the Elaborated Intrusion theory of desire. FIT trains the habitual use of personalised, affective, goal-directed mental imagery to plan behaviours, anticipate obstacles, and mentally try out solutions from previous successes. It is delivered in the client-centred style of Motivational Interviewing (MI). We tested the impact of FIT on weight loss, compared with time- and contact-matched MI.

Design

We recruited 141 adults with BMI (kg/m²) ≥25, via a community newspaper, to a single-centre randomised controlled trial. Participants were allocated to one of two active interventions: FIT or MI. Primary data collection and analyses were conducted by researchers blind to interventions. All participants received two sessions of their allocated intervention; the first face-to-face (1 h), the second by phone (maximum 45 min). Booster calls of up to 15 min were provided every 2 weeks for 3 months, then once-monthly until 6 months. Maximum contact time was 4 h of individual consultation. Participants were assessed at Baseline, at the end of the intervention phase (6 months), and again 12 months post-baseline.

Main outcome measures

Weight (kg) and waist circumference (WC, cm) reductions at 6 and 12 months.

Results

FIT participants (N = 59) lost 4.11 kg and 7.02 cm of WC, compared to .74 kg and 2.72 cm in the MI group (N = 55) at 6 months (weight mean difference (WMD) = 3.37 kg, p < .001, 95% CI [−5.2, −2.1], waist-circumference mean difference (WCMD) = 4.3 cm, p < .001, 95% CI [−6.3,−2.6]). Between-group differences were maintained and increased at month 12: FIT participants lost 6.44 kg (W) and 9.1 cm (WC) compared to the MI who lost .67 kg and 2.46 cm (WMD = 5.77 kg, p < .001, 95% CI [−7.5, −4.4], WCMD = 6.64 cm, p < .001, 95% CI [−7.5, −4.4]).

Conclusion

FIT is a theoretically informed motivational intervention which offers substantial benefits for weight loss and maintenance of weight reduction, compared with MI alone, despite including no lifestyle education or advice.

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Acknowledgements

We would like to thank the research assistants who have tirelessly supported this project: Despina Djama, Lloyd Taylor, Kirsten Woodman, and Marina Khalil.

Funding

This research was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula.

Author information

Affiliations

  1. School of Psychology, Cognition Institute, University of Plymouth, Plymouth, UK

    • Linda Solbrig
    • , Ben Whalley
    • , Jon May
    •  & Jackie Andrade
  2. NIHR CLAHRC South-West Peninsula, Plymouth, UK

    • Linda Solbrig
  3. Institute for Health & Biomedical Innovation, Centre for Children’s Health Research, Brisbane, Australia

    • David J. Kavanagh
  4. School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia

    • David J. Kavanagh
  5. School of Health Professions (Dietetics), University of Plymouth, Plymouth, UK

    • Tracey Parkin
  6. School of Nursing & Midwifery, University of Plymouth, Plymouth, UK

    • Ray Jones

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Jackie Andrade.

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DOI

https://doi.org/10.1038/s41366-018-0122-1