Abstract Details

Title Motivation for Behavioral Change for Weight Loss in Obese Patients with Acute Stroke or TIA

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-005

Objective To evaluate motivation for behavioral change for weight loss in overweight/obese patients with recent stroke/TIA.

Background Obesity is exceedingly common in patients with stroke. Treating obesity through weight loss improves vascular risk factors. Despite the benefits, many obese patients do not lose weight, likely because achieving significant weight loss requires compliance with intensive behavioral modifications. Motivated patients are more likely to adhere to and succeed with weight loss interventions.

Design/Methods Using a validated questionnaire, we assessed overweight/obese patients with recent stroke/TIA. We categorized patients’ stage of behavioral change by examining their perception of obesity and readiness to lose weight. The stages, based on the Transtheoretical Model are precontemplation, contemplation, preparation, action and maintenance. We next determined patients’ processes of behavioral change, which are attitudes and behaviors modified in transition from stage to stage. We focus on the emotional re-evaluation (EmR) process, which quantifies the psychological impact of obesity on an individual, with a higher score equating a higher emotional impact (scored 0 to 100).

Results 35 subjects were included in this study (mean age 62 [SD 11], female sex 18 [51%] and mean BMI 37 [SD 9]). Cardiovascular risk factors were highly prevalent: hypertension 86%, hyperlipidemia 66%, diabetes 37%.
31% (n=11) of patients were not ready to change (precontemplative or contemplative stages), while 69% (n=24) of patients were ready to change their weight (preparation, action or maintenance stages). Patients who were ready to change their weight had a significantly higher emotional impact of obesity compared to those not ready to change (mean EmR score 79 [SD 14] vs. 66 [SD 18], two-sided t-test p<0.05).

Conclusions Our preliminary results suggest that without counseling or specific intervention, approximately two-thirds of obese patients with stroke/TIA are motivated, and emotionally ready, to lose weight. Ongoing work will test the effectiveness of weight loss strategies for these patients.

Authors/Disclosures
Hailey A. Orgass, PA (NYP Weill Cornell Medical Center) PRESENTER	No disclosure on file
Emily Daigle, MD	No disclosure on file
Zachary King (Yale)	No disclosure on file
Cora Ormseth	No disclosure on file
Sara Jasak	No disclosure on file
Emily J. Gilmore, MD (Yale University School of Medicine)	Dr. Gilmore has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for carpl.ai. Dr. Gilmore has received personal compensation in the range of $0-$499 for serving as a Consultant for AAN. Dr. Gilmore has received research support from NIH.
Lauren H. Sansing, MD	Dr. Sansing has nothing to disclose.
Hardik Amin, MD (Yale University School of Medicine)	No disclosure on file
Walter N. Kernan, MD (Yale Medical School)	Dr. Kernan has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for various law firms.
Guido J. Falcone, MD (Yale School of Medicine)	The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.
Kevin N. Sheth, MD, FAAN (Yale UniversityDivision of Neuro and Critical Care)	Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.
Jennifer L. Dearborn-Tomazos, MD (Beth Israel Deaconess Medical Center)	An immediate family member of Dr. Dearborn-Tomazos has received personal compensation for serving as an employee of PTC Therapeutics. An immediate family member of Dr. Dearborn-Tomazos has received personal compensation for serving as an employee of Alexion Pharmaceuticals. Dr. Dearborn-Tomazos has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Qmetis. An immediate family member of Dr. Dearborn-Tomazos has stock in Alexion Pharmacueticals. The institution of Dr. Dearborn-Tomazos has received research support from BMS.

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