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Danielle Wadsworth, PhD, on Weight Management in Overweight College Students During the Pandemic

– Personal contact topped online education, study found


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Medical Today

College students eating away from home and studying for long hours encounter challenges in managing their weight, and COVID-19 only exacerbated the problem. The adverse impact of pandemic restrictions on anthropometrics in this population was the impetus for a small randomized controlled trial conducted by Kameron Suire, PhD, ACSM-EP, of Berry College in Mount Berry, Georgia, and colleagues.

The researchers created a "motivational interviewing" intervention and concluded in their study in that use of the intervention in overweight college students during the pandemic was associated with a positive trend in body composition maintenance compared with online education.

Co-author Danielle D. Wadsworth, PhD, now director of the Exercise Adherence and Obesity Prevention Laboratory of Auburn University in Alabama, elaborated on the findings in the following interview.

What was the impetus for the study?

Wadsworth: According to a recent national , 38.7% of undergraduates are overweight or obese by self-reported height and weight. Obesogenic behaviors such as lack of physical activity or excessive caloric consumption were exacerbated during the coronavirus pandemic. Our exploratory study sought to determine the relative effectiveness of a direct motivational interviewing (MI) intervention versus online education (control) on body composition and psychological factors known as self-determination theory constructs (SDTs) in 40 overweight college students at a single university.

The MI group participated in 6 monthly interviews: three face-to-face sessions before the pandemic and three video chat interviews after the outbreak. The control group received 6 monthly electronic education modules. Participants' body composition was measured with an iDEXA scan, and variables were assessed via surveys. SDT variables included three psychological needs of autonomy, competence, and relatedness, as well as the following types of motivation: amotivation, external regulation, identified regulation, integrated regulation, and intrinsic regulation.

What's new about this trial?

Wadsworth: Body composition data on college students right before and after the onset of the pandemic are novel, and this intervention provided much-needed information. Furthermore, MI interventions are lacking in this population.

What were the main findings?

Wadsworth: Overall there were significant differences between the MI and online education group in fat mass, lean mass, and body fat percentage, as well as in several SDT indicators.

We found a difference of 2.43% in body fat between the two groups in favor of MI at the end of the study, which is similar to the difference of 2.5% reported by in a study of the impact of an aerobic exercise program in female students.

Participants in the control group gained a substantial amount of fat mass while losing lean mass, potentially signaling additional health impacts from large shutdowns throughout the pandemic.

MI also appears to have improved multiple SDT-related constructs, suggesting the potential for future interventions combining MI and SDT.

For example, we found that the MI group reported an increase in mean autonomy (M = 2.50, SD = 3.70) compared with a decrease (M= –3.80, SD = 4.78) in the control group. That meant that MI participants increased their feelings of autonomy. Additionally, the MI group showed decreases in amotivation, or a lack of motivation (M = –2.25, SD = 2.90) versus a decrease (M = – 0.90, SD = 3.48) in controls, suggesting that this group was more motivated than controls.

On the variable of external regulation, there was a mean decrease in the MI group (M = –1.67, SD = 3.60) versus an increase (M = 3.00, SD = 7.56) in the control group. The intervention group also had an increase (M = 6.67, SD = 7.88) in mean intrinsic regulation compared with a decrease (M = –6.00, SD = 13.86) in controls. These favorable increases in motivation may lead to further participation in exercise behavior or other weight management practices.

What are the anthropometric implications of these results?

Wadsworth: Overall, MI demonstrated a positive trend in body composition maintenance versus online education, and the results suggest that studies utilizing MI should further investigate the relationship between MI, SDT, and body composition.

This study also offers insight into how MI effects are sustainable in varying environments and delivery modes.

Future interventions that demonstrate an impact on anthropometric status are needed in the college student population. Approaches that utilize follow-up periods and measure body composition would make beneficial contributions to the current literature.

Read the study here and expert commentary about it here.

Suire and Wadsworth noted having no conflicts of interest to report; one co-author reported financial relationships with Merck and MediMergent.

Primary Source

Obesity Pillars

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OMA Publications Corner