public interface IGobbler
{
    bool Gobble(ref int amount);
}

delegate void GobbleCallback(ref int amount);     // needed for Callback
delegate bool GobbleReturns(ref int amount);      // needed for Returns

var mock = new Mock();
mock.Setup(m => m.Gobble(ref It.Ref.IsAny))  // match any value passed by-ref
    .Callback(new GobbleCallback((ref int amount) =>
     {
         if (amount > 0)
         {
             Console.WriteLine("Gobbling...");
             amount -= 1;
         }
     }))
    .Returns(new GobbleReturns((ref int amount) => amount > 0));

int a = 5;
bool gobbleSomeMore = true;
while (gobbleSomeMore)
{
    gobbleSomeMore = mock.Object.Gobble(ref a);
}