Motivational interviews and digital health guidance improve postoperative weight management in obese children

doi:10.4240/wjgs.119830

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Publication Name

World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Randomized Controlled Trial

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Aug 27, 2026; 18(8): 119830
Published online Aug 27, 2026. doi: 10.4240/wjgs.119830

Motivational interviews and digital health guidance improve postoperative weight management in obese children

Xiao-Qian Dun, Si Chen

Xiao-Qian Dun, Si Chen, Department of Pediatric Rehabilitation, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050000, Hebei Province, China

Author contributions: Dun XQ contributed to conceptualization, methodology, validation, formal analysis, investigation, writing original draft, writing review and editing, visualization, project administration; Chen S contributed to conceptualization, methodology, software, investigation, data curation, writing original draft, writing review and editing, supervision, funding acquisition.

AI contribution statement: AI tools (specifically ChatGPT) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.

Institutional review board statement: This study was approved by the Institutional Review Board of Shijiazhuang Maternal and Child Health Hospital (No. 202132).

Clinical trial registration statement: This study was not registered as a clinical trial.

Informed consent statement: Informed consent was obtained from the legal guardians of all participating children, and assent was obtained from the children themselves.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

Corresponding author: Si Chen, MD, Doctor, Department of Pediatric Rehabilitation, Shijiazhuang Maternal and Child Health Hospital, No. 396 Youyi South Street, Qiaoxi District, Shijiazhuang 050000, Hebei Province, China. chensi_ab123@163.com

Received: April 8, 2026
Revised: May 13, 2026
Accepted: June 2, 2026
Published online: August 27, 2026
Processing time: 130 Days and 11 Hours

Abstract

BACKGROUND

Childhood obesity is a major public health issue, with obesity rates reaching 20.8% among 14-year-olds and increasing with age. Metabolic and bariatric surgery is the most effective treatment for moderate to severe obesity, but postoperative weight regain and reduced quality of life often occur due to poor lifestyle adherence. Digital health guidance interventions have shown benefits in improving disease understanding and quality of life, yet single interventions have limited effectiveness. Motivational interviewing (MI), a person-centered communication approach, enhances medication adherence and metabolic control. This study integrates MI with digital health guidance to evaluate its impact on lifestyle adherence and weight management in obese children after metabolic and bariatric surgery.

AIM

To explore the impact of MI combined with digital health guidance on lifestyle adherence and weight management in obese children after metabolic and bariatric surgery.

METHODS

A total of 40 obese children who underwent metabolic and bariatric surgery in our hospital from January 2021 to January 2025 were selected and randomly divided into two groups. The control group (20 cases) received one month of digital health education intervention, while the observation group (20 cases) received one month of MI intervention in addition to the control group’s intervention. The lifestyle adherence rate, diet and exercise status, weight control indicators, lipid metabolism indicators, body image and self-esteem scores, and quality of life scores before and after one month of intervention were compared between the two groups.

RESULTS

After one month of intervention, the observation group showed higher overall lifestyle adherence rate, fruit and vegetable intake, moderate-to-vigorous physical activity duration, body image score, Rosenberg Self-Esteem Scale score, high-density lipoprotein cholesterol level, and scores in all dimensions of the 36-Item Short Form Health Survey, while exhibiting lower energy intake, sugary beverage consumption, body weight, body mass index, waist circumference, hip circumference, total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels compared to the control group (P < 0.05).

CONCLUSION

The combined intervention of digital health guidance and MI showed preliminary short-term improvements in lifestyle adherence, diet and exercise habits, weight control, lipid metabolism, and quality of life in obese children after metabolic and bariatric surgery over a one-month follow-up period.

Keywords: Motivational interviews; Digital health guidance; Obesity; Lifestyle compliance; Weight loss metabolic surgery; Weight management

Core Tip: This study introduces a combined intervention of motivational interviewing (MI) and digital health guidance for pediatric obesity management. Our findings reveal that integrating MI with digital support significantly enhances lifestyle compliance, dietary and exercise behaviors, weight control, lipid profiles, and quality of life in children after metabolic and bariatric surgery. The MI approach, which focuses on eliciting patient motivation, synergizes with digital monitoring to sustain long-term behavior change, offering a novel and effective model for postoperative care in this vulnerable population.