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Readiness for behaviour change in non-alcoholic fatty liver disease: implications for multidisciplinary care models

Authors

  • Karen E. Stewart,

    Corresponding author
    1. Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
    2. Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
    • Correspondence

      Karen Stewart PhD, West Hospital, 8th Floor, 1200 East Broad St, Richmond VA 23298, USA

      Tel: +1 (804) 828 6314

      Fax: +1 (804) 828 2992

      e-mail: kstewart2@mcvh-vcu.edu

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  • Deborah L. Haller,

    1. Department of Psychiatry, Columbia University, New York, NY, USA
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  • Carol Sargeant,

    1. Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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  • James L. Levenson,

    1. Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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  • Puneet Puri,

    1. Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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  • Arun J. Sanyal

    1. Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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Abstract

Background & Aims

Weight management is a cornerstone of treatment for overweight/obese persons with non-alcoholic fatty liver disease (NAFLD). This exploratory study sought to: (i) evaluate readiness to change weight-related behaviours; (ii) assess psychosocial characteristics that may interfere with weight loss; and (iii) evaluate how baseline psychosocial features associate with 6-month change in weight in persons with NAFLD receiving standard medical care. The purpose of this investigation was to develop hypotheses regarding relationships between psychosocial factors and weight for use in future fully powered studies and clinical interventions

Methods

Fifty-eight overweight/obese participants with NAFLD completed baseline measures of personality, psychiatric symptoms and readiness for behaviour change and were followed up for 6 months in standard care.

Results

One-third of participants (31.0%) were not interested in making weight-related behaviour changes; 58.6% were considering making a change, and 10.4% of individuals were actively working on or preparing to change. Six-month change in weight was non-significant and was not associated with baseline readiness for change. Depression, low conscientiousness and high neuroticism were associated with higher weight at 6-month follow-up with small to large effect sizes.

Conclusions

Although participants received nutritional education and guidance, very few individuals presented in the active stage of change. Although readiness for change did not predict subsequent change in weight, personality factors and psychiatric symptoms were associated with weight outcomes. Integrated multidisciplinary approaches that address psychiatric needs and provide behavioural support for weight loss may help patients with NAFLD implement sustained lifestyle changes.

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