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For decades, individuals struggling with obesity have faced an ongoing cycle of weight loss and regain. While glucagon-like peptide-1 receptor agonists (GLP-1s) have emerged as a promising treatment—helping patients lose up to 22% of their total body weight—they are not a standalone solution. These medications do not address other critical factors such as behavior, biology, and environment.
Experts suggest that motivational interviewing (MI), a patient-centered counseling technique, may be the missing piece in helping individuals maintain long-term weight loss.
The Role of Motivational Interviewing
Dr. Kathryn Ilonka Pollak, a professor in population health sciences at Duke Cancer Institute, highlights the societal biases that individuals with obesity often face, including from healthcare professionals. Stigmatizing language, even when unintended, can negatively impact patients’ motivation and self-esteem.
MI shifts the conversation by focusing on patient autonomy, self-efficacy, and collaboration. Rather than instructing patients on what they should do, MI practitioners guide them toward discovering their own motivations for change.
Carol DeFrancesco, a Portland-based researcher and member of the Motivational Interviewing Network of Trainers (MINT), describes MI as a practice of careful and reflective listening. “It’s about compassion, respect, and drawing out the patient’s goals and desires,” she explains.
Putting Patients in Control
Dr. Angela Fitch, an obesity medicine specialist and co-founder of Knownwell Health, emphasizes the importance of engaging patients in their own healthcare journey. “Instead of lecturing, we should aim for collaboration and buy-in,” she says.
Dr. Robert Kushner, an obesity medicine specialist at Northwestern University, shares an example from his research: a patient initially expressed a desire to lose weight but later revealed that their true motivation was to stay active and play with their children. MI techniques help patients articulate these deeper motivations, fostering long-term commitment to lifestyle changes.
Open-ended questions, such as “What challenges are you facing?” or “How do you feel about your progress?” encourage meaningful dialogue. Simple affirmations and empathetic statements further reinforce patient confidence and engagement.
A Practical Approach for Clinicians
Time constraints in primary care make it challenging to incorporate MI into every patient interaction. However, Dr. Fitch suggests that even small MI techniques can be effective. Practicing one method a day, such as reflective listening or empathy, can gradually integrate MI into routine care.
Dr. Damara Gutnick, a professor at Montefiore Medical Center, shares how learning MI revitalized her medical practice. “I was burnt out and exhausted, but MI brought joy back into my work. It transformed my patient relationships and reduced resistance to treatment.”
As MI continues to gain recognition, healthcare providers are finding it to be a valuable tool in improving long-term outcomes for obesity treatment. When combined with medical therapies like GLP-1s, MI may help patients achieve lasting weight loss and a healthier lifestyle.
Disclaimer: This article is for informational purposes only and should not be taken as medical advice. Readers should consult a qualified healthcare professional before making any changes to their weight loss strategy or treatment plan.
