The Mind Your Health Project: a Randomized Controlled Trial of an Innovative Behavioral Treatment for Obesity

Overview

Journal Obesity (Silver Spring)

Specialties Endocrinology
Nutritional Sciences
Physiology

Date 2013 May 14

PMID 23666772

Citations 85

Authors

E M Forman

M L Butryn

A S Juarascio

L E Bradley

M R Lowe

J D Herbert

J A Shaw

Affiliations

Soon will be listed here.

Abstract

Objective: To determine whether acceptance-based behavioral treatment (ABT) would result in greater weight loss than standard behavioral treatment (SBT), and whether treatment effects were moderated by interventionist expertise or participants' susceptibility to eating cues. Recent research suggests that poor long-term weight-control outcomes are due to lapses in adherence to weight-control behaviors and that adherence might be improved by enhancing SBT with acceptance-based behavioral strategies.

Design And Methods: Overweight participants (n = 128) were randomly assigned to 40 weeks of SBT or ABT.

Results: Both groups produced significant weight loss, and when administered by experts, weight loss was significantly higher in ABT than SBT at post-treatment (13.17% vs. 7.54%) and 6-month follow-up (10.98% vs. 4.83%). Moreover, 64% of those receiving ABT from experts (vs. 46% for SBT) maintained at least a 10% weight loss by follow-up. Moderation analyses revealed a powerful advantage, at follow-up, of ABT over SBT in those potentially more susceptible to eating cues. For participants with greater baseline depression symptomology, weight loss at follow-up was 11.18% in ABT versus 4.63% in SBT; other comparisons were 10.51% versus 6.00% (emotional eating), 8.29% versus 6.35% (disinhibition), and 9.70% versus 4.46% (responsivity to food cues). Mediation analyses produced partial support for theorized food-related psychological acceptance as a mechanism of action.

Conclusions: Results offer strong support for the incorporation of acceptance-based skills into behavioral weight loss treatments, particularly among those with greater levels of depression, responsivity to the food environment, disinhibition, and emotional eating, and especially when interventions are provided by weight-control experts.

Citing Articles

Emotional Eating Interventions for Adults Living With Overweight and Obesity: A Systematic Review and Meta-Analysis of Behaviour Change Techniques.

Power D, Jones A, Keyworth C, Dhir P, Griffiths A, Shepherd K J Hum Nutr Diet. 2025; 38(1):e13410.

PMID: 39763344 PMC: 11704659. DOI: 10.1111/jhn.13410.

Psychological interventions for weight reduction and sustained weight reduction in adults with overweight and obesity: a scoping review.

Hamer O, Kuroski J, Bray E, Harris C, Blundell A, Schneider E BMJ Open. 2024; 14(12):e082973.

PMID: 39622564 PMC: 11624810. DOI: 10.1136/bmjopen-2023-082973.

The impact of behavioral weight management interventions on eating behavior traits in adults with overweight or obesity: A systematic review and meta-analysis.

Kudlek L, Eustachio Colombo P, Ahern A, Tait S, Reid N, Wickramarachchi M Obes Rev. 2024; 26(4):e13871.

PMID: 39572922 PMC: 11884964. DOI: 10.1111/obr.13871.

Weight Loss Programs: Why Do They Fail? A Multidimensional Approach for Obesity Management.

Khattab R Curr Nutr Rep. 2024; 13(3):478-499.

PMID: 38861120 DOI: 10.1007/s13668-024-00551-x.

Socioeconomic Characteristics and the Home Food Environment Are Associated With Feeding Healthful and Discretionary Foods During the First Year of Life in the Pregnancy Eating Attributes Study.

Nansel T, Schwedhelm C, Lipsky L, Faith M, Siega-Riz A J Acad Nutr Diet. 2024; 125(2):228-238.e1.

PMID: 38777149 PMC: 11576486. DOI: 10.1016/j.jand.2024.05.011.

References

Butryn M, Webb V, Wadden T . Behavioral treatment of obesity. Psychiatr Clin North Am. 2011; 34(4):841-59. PMC: 3233993. DOI: 10.1016/j.psc.2011.08.006. View

Lillis J, Hayes S, Bunting K, Masuda A . Teaching acceptance and mindfulness to improve the lives of the obese: a preliminary test of a theoretical model. Ann Behav Med. 2009; 37(1):58-69. DOI: 10.1007/s12160-009-9083-x. View

Abramowitz J, Tolin D, Street G . Paradoxical effects of thought suppression: a meta-analysis of controlled studies. Clin Psychol Rev. 2001; 21(5):683-703. DOI: 10.1016/s0272-7358(00)00057-x. View

Timmerman G, Brown A . The effect of a mindful restaurant eating intervention on weight management in women. J Nutr Educ Behav. 2012; 44(1):22-8. PMC: 3259454. DOI: 10.1016/j.jneb.2011.03.143. View

Butryn M, Forman E, Hoffman K, Shaw J, Juarascio A . A pilot study of acceptance and commitment therapy for promotion of physical activity. J Phys Act Health. 2011; 8(4):516-22. DOI: 10.1123/jpah.8.4.516. View

Niemeier H, Leahey T, Palm Reed K, Brown R, Wing R . An acceptance-based behavioral intervention for weight loss: a pilot study. Behav Ther. 2012; 43(2):427-35. PMC: 3535069. DOI: 10.1016/j.beth.2011.10.005. View

Gifford E, Lillis J . Avoidance and inflexibility as a common clinical pathway in obesity and smoking treatment. J Health Psychol. 2009; 14(7):992-6. DOI: 10.1177/1359105309342304. View

Arnow B, Kenardy J, Agras W . The Emotional Eating Scale: the development of a measure to assess coping with negative affect by eating. Int J Eat Disord. 1995; 18(1):79-90. DOI: 10.1002/1098-108x(199507)18:1<79::aid-eat2260180109>3.0.co;2-v. View

Tapper K, Shaw C, Ilsley J, Hill A, Bond F, Moore L . Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite. 2008; 52(2):396-404. DOI: 10.1016/j.appet.2008.11.012. View

10.

Lowe M, Butryn M, Didie E, Annunziato R, Thomas J, Crerand C . The Power of Food Scale. A new measure of the psychological influence of the food environment. Appetite. 2009; 53(1):114-8. DOI: 10.1016/j.appet.2009.05.016. View

11.

Ward A, Mann T . Don't mind if I do: disinhibited eating under cognitive load. J Pers Soc Psychol. 2000; 78(4):753-63. DOI: 10.1037//0022-3514.78.4.753. View

12.

Steer R, Cavalieri T, Leonard D, Beck A . Use of the Beck Depression Inventory for Primary Care to screen for major depression disorders. Gen Hosp Psychiatry. 1999; 21(2):106-11. DOI: 10.1016/s0163-8343(98)00070-x. View

13.

Cappelleri J, Bushmakin A, Gerber R, Leidy N, Sexton C, Lowe M . Psychometric analysis of the Three-Factor Eating Questionnaire-R21: results from a large diverse sample of obese and non-obese participants. Int J Obes (Lond). 2009; 33(6):611-20. DOI: 10.1038/ijo.2009.74. View

14.

Hooper N, Sandoz E, Ashton J, Clarke A, McHugh L . Comparing thought suppression and acceptance as coping techniques for food cravings. Eat Behav. 2011; 13(1):62-4. DOI: 10.1016/j.eatbeh.2011.10.002. View

15.

Marlatt G, George W . Relapse prevention: introduction and overview of the model. Br J Addict. 1984; 79(3):261-73. DOI: 10.1111/j.1360-0443.1984.tb00274.x. View

16.

Arch J, Eifert G, Davies C, Plumb Vilardaga J, Rose R, Craske M . Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders. J Consult Clin Psychol. 2012; 80(5):750-65. PMC: 4718567. DOI: 10.1037/a0028310. View

17.

Forman E, Chapman J, Herbert J, Goetter E, Yuen E, Moitra E . Using session-by-session measurement to compare mechanisms of action for acceptance and commitment therapy and cognitive therapy. Behav Ther. 2012; 43(2):341-54. DOI: 10.1016/j.beth.2011.07.004. View

18.

Klem M, Wing R, McGuire M, Seagle H, Hill J . A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr. 1997; 66(2):239-46. DOI: 10.1093/ajcn/66.2.239. View

19.

Niemeier H, Phelan S, Fava J, Wing R . Internal disinhibition predicts weight regain following weight loss and weight loss maintenance. Obesity (Silver Spring). 2007; 15(10):2485-94. DOI: 10.1038/oby.2007.295. View

20.

Wing R, Tate D, Gorin A, Raynor H, Fava J . A self-regulation program for maintenance of weight loss. N Engl J Med. 2006; 355(15):1563-71. DOI: 10.1056/NEJMoa061883. View