Is the Small Changes programme clinically effective for adults who are obese?

This thesis concerns the treatment of (N=148) male and female clients in a weight management programme: Small Changes the thesis compares treatment as usual with a new approach using motivational interviewing. Firstly a preface sets out the historical context of Small Changes and how it developed and was originally funded before the aims of the thesis and the detail encompassed in each chapter are set out. Following this an introduction chapter presents the key constructs and theories surrounding motivational interviewing. This leads into study 1, a systematic review addressing the question: What should be included in a comprehensive weight management programme? The conclusion to this question is a mixture of input from: nutrition and exercise expertise combined with a clear behavioural approach, measures that encompass important clinical parameters, other than just weight, and sufficient length of follow-up post treatment. This conclusion forms the basis of the study 2 literature review which focusses on the contribution of motivational interviewing for affecting exercise and nutrition behaviours with the aim of improving weight management outcomes. The literature review leads into the methodology for study 2 which outlines the measures used, the follow-up period and the detail of what was done in study 2; sufficiently clearly for others to replicate what was done. From this chapter a separate results chapter reveals the statistical results for the outcome measures included in study 2. The discussion chapter then follows and focusses on the interpretation, critique and analysis of the results and relates these back to the literature presented in the literature review for study 2. Finally conclusions and short-comings of the study 2 investigation are explored and further research considerations made.