J Obes Metab Syndr 2022; 31(1): 88-90
Published online March 30, 2022 https://doi.org/10.7570/jomes22006
Copyright © Korean Society for the Study of Obesity.
1Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand; 2Université Clermont Auvergne, EA 4281, Laboratoire Activité, Connaissance, Transmission, Éducation (ACTé), Clermont-Ferrand, France
Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), BP 80026, F-63171 Aubière cedex, France
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While there is a growing body of evidence regarding the metabolic, physiological, or functional benefits of multi-disciplinary weight loss interventions in adolescents who are overweight and obese, their effects on mental health, well-being, health-related quality of life (HRQOL), and perceived physical-fitness and health remain less explored. Our research group recently tried to better understand these potential psycho-physiological responses to multi-disciplinary weight loss programs by considering different modalities of exercise interventions in obese adolescents.1 In particular, we recently reported in
In an Letter to the Editor, Choi3, while pointing out the quality and relevance of our work and its results, also stressed the necessity to fully consider the nature of the psychological support received by the adolescents, as well as the potential implication of their initial motivation when engaging in such interventions. We would like to thank Choi3 for raising these important points, giving us the opportunity to complete our initial publication, and to initiate what we believe are necessary discussions regarding the role and implications of adolescent (and overall patients) motivation and engagement in clinical interventions.
First, the psychological intervention the adolescents received a monthly 90-minute session of psychological support through individual consultations with a professional. Sessions focused on self-esteem and emotional, social, and familial relationships and issues. As suggested by Choi3, psychological sessions can focus on motivation of patients to engage in the intervention efforts and to lose weight, which will impact their engagement with the program and affect the success of the intervention. However, our sessions mainly focused on coping with social and emotional difficulties that often accompany pediatric obesity.
In his paper, Choi3 describes the importance of considering patient motivation, adherence, and engagement for intervention success. We agree and would like to take advantage of this opportunity to explore these concepts and clarify their potential implication for success of behavioral and clinical programs.
Second, it seems important to clarify that our initial published results deal with the effect of the intervention on the adolescents’ quality of life and perceived health and fitness, and that psychometrics can be improved independently of the motivation of the patients. Indeed, improvements in body composition and physical fitness have been found in association with improved HRQOL and health or fitness perception despite a lack of motivation.
This leads us to what we believe is an excellent opportunity to clarify the concept of motivation, which is an essential component for the success of our interventions. Indeed, in line with what is suggested by Choi3, it appears necessary to consider the self-reported motivation of patients (initial and its evolution) to follow a weight loss intervention and behavioral
Although complex and difficult to properly evaluate and assess, such
While we have a basic knowledge of the mechanics of weight loss, we must better understand why the achieved benefits of our interventions in some patients remain below expectations and the estimated prescription and how to motivate such patients to maintain the weight loss postintervention. We believe that increased consideration of patient intrinsic motivation to begin and continue the intervention, independent of initial expressed motivation, might help us improve both the effects of the program and individual sustainability over time. This effort clearly illustrates the need for larger multi-disciplinary strategies for prevention and treatment of overweight status and obesity and for development of additional research studies combining psychosocial, physiological, and philosophical approaches.
The authors declare no conflict of interest.
Study concept and design: all authors; acquisition of data: all authors; analysis and interpretation of data: all authors; drafting of the manuscript: all authors; critical revision of the manuscript: all authors; statistical analysis: all authors; administrative, technical, or material support: all authors; and study supervision: all authors.