Psychiatry Newsletter - The POWER to Lose Weight
The POWER to Lose Weight
Date: May 1, 2014
Behavioral weight loss techniques delivered over the phone by coaches trained in motivational interviewing can help overweight and obese individuals achieve success, psychologist Janelle Coughlin and colleagues have found.
In a recent clinical trial called Practice-based Opportunities for Weight Reduction (POWER), Coughlin helped train coaches how to provide the techniques, including asking open-ended questions, exploring participants’ feelings of ambivalence and supporting their movement toward change. Under the guidance of the study’s intervention team, the coaches also incorporated behavioral self-management approaches to help participants set weight-related goals; self-monitor weight and weight-related behaviors like exercise and reduced caloric intake; increase self-efficacy and social support; and solve problems.
The trial, published in 2011 in The New England Journal of Medicine, showed that among 415 obese individuals, telephone coaching worked as well as in-person counseling in aiding weight loss efforts. The trial was led by internist and epidemiologist Lawrence Appel, director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins, with help from Healthways, a disease management and wellness company that provides customers (often employers) with tools and programs for improving wellness.
“It’s very rewarding to help oversee a project that can influence so many people,” Coughlin says. “Even a 5 to 10 percent weight loss is associated with health benefits, and a lot of people lost much more than that in this trial.”
Now the tenets behind POWER are central to Innergy, a weight-loss program being offered to Johns Hopkins Health System employees. The two-year program helps participants develop eating and exercise strategies to maintain a healthy weight throughout their lives. Users track calories, activity and weight online; receive weekly emails with strategies and recipes; and talk by telephone with a trained weight-loss coach who stays with them for the entire program. Innergy was developed and is offered in a collaboration between Johns Hopkins Medicine and Healthways; Coughlin and her POWER colleagues are consultants for the program.
As for research, Johns Hopkins experts including Coughlin and Appel are now trying these weight-loss techniques in a group of breast cancer survivors, whose risk of recurrent breast cancer may diminish with weight loss. Psychiatry’s Colleen Schreyer is helping deliver the interventions in this trial, led by oncologist Vered Stearns, co-director of Johns Hopkins’ Breast Cancer Program.
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