Acceptance-based Versus Standard Behavioral Treatment for Obesity: Results from the Mind Your Health Randomized Controlled Trial

Overview

Journal Obesity (Silver Spring)

Specialties Endocrinology
Nutritional Sciences
Physiology

Date 2016 Sep 28

PMID 27670400

Citations 77

Authors

Evan M Forman

Meghan L Butryn

Stephanie M Manasse

Ross D Crosby

Stephanie P Goldstein

Emily P Wyckoff

J Graham Thomas

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the efficacy, as well as potential moderators and mediators, of a revised acceptance-based behavioral treatment (ABT) for obesity, relative to standard behavioral treatment (SBT).

Methods: Participants with overweight and obesity (n = 190) were randomized to 25 sessions of ABT or SBT over 1 year. Primary outcome (weight), mediator, and moderator measurements were taken at baseline, 6 months, and/or 12 months, and weight was also measured every session.

Results: Participants assigned to ABT attained a significantly greater 12-month weight loss (13.3% ± 0.83%) than did those assigned to SBT (9.8% ± 0.87%; P = 0.005). A condition by quadratic time effect on session-by-session weights (P = 0.01) indicated that SBT had a shallower trajectory of weight loss followed by an upward deflection. ABT participants were also more likely to maintain a 10% weight loss at 12 months (64.0% vs. 48.9%; P = 0.04). No evidence of moderation was found. Results supported the mediating role of autonomous motivation and psychological acceptance of food-related urges.

Conclusions: Behavioral weight loss outcomes can be improved by integrating self-regulation skills that are reflected in acceptance-based treatment, i.e., tolerating discomfort and reduction in pleasure, enacting commitment to valued behavior, and being mindfully aware during moments of decision-making.

Citing Articles

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 past, present, and future of behavioral obesity treatment.

Chao A, Moore M, Wadden T Int J Obes (Lond). 2024; 49(2):196-205.

PMID: 38678143 PMC: 11729970. DOI: 10.1038/s41366-024-01525-3.

The moderating and mediating role of eating behaviour traits in acceptance and commitment therapy-based weight management interventions: protocol for an individual participant data meta-analysis.

Kudlek L, Mueller J, Eustacio Colombo P, Sharp S, Griffin S, Ahern A BMJ Open. 2023; 13(12):e076411.

PMID: 38081662 PMC: 10729174. DOI: 10.1136/bmjopen-2023-076411.

Digital communication and virtual reality for extending the behavioural treatment of obesity - the patients' perspective: results of an online survey in Germany.

Luck-Sikorski C, Hochrein R, Dollinger N, Wienrich C, Gemesi K, Holzmann S BMC Med Inform Decis Mak. 2023; 23(1):100.

PMID: 37226164 PMC: 10206569. DOI: 10.1186/s12911-023-02197-1.

Psychological Support Strategies for Adults With Type 2 Diabetes in a Very Low-Carbohydrate Web-Based Program: Randomized Controlled Trial.

Saslow L, Missel A, OBrien A, Kim S, Hecht F, Moskowitz J JMIR Diabetes. 2023; 8:e44295.

PMID: 37166961 PMC: 10214122. DOI: 10.2196/44295.

References

Forman E, Butryn M . A new look at the science of weight control: how acceptance and commitment strategies can address the challenge of self-regulation. Appetite. 2014; 84:171-80. PMC: 4314333. DOI: 10.1016/j.appet.2014.10.004. View

Goodwin C, Forman E, Herbert J, Butryn M, Ledley G . A pilot study examining the initial effectiveness of a brief acceptance-based behavior therapy for modifying diet and physical activity among cardiac patients. Behav Modif. 2011; 36(2):199-217. DOI: 10.1177/0145445511427770. View

Cappelleri J, Bushmakin A, Gerber R, Leidy N, Sexton C, Karlsson J . Evaluating the Power of Food Scale in obese subjects and a general sample of individuals: development and measurement properties. Int J Obes (Lond). 2009; 33(8):913-22. DOI: 10.1038/ijo.2009.107. View

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

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

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

Stunkard A, Messick S . The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res. 1985; 29(1):71-83. DOI: 10.1016/0022-3999(85)90010-8. View

. The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care. 2002; 25(12):2165-71. PMC: 1282458. DOI: 10.2337/diacare.25.12.2165. View

Franz M, VanWormer J, Crain A, Boucher J, Histon T, Caplan W . Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc. 2007; 107(10):1755-67. DOI: 10.1016/j.jada.2007.07.017. View

10.

Levesque C, Williams G, Elliot D, Pickering M, Bodenhamer B, Finley P . Validating the theoretical structure of the Treatment Self-Regulation Questionnaire (TSRQ) across three different health behaviors. Health Educ Res. 2006; 22(5):691-702. DOI: 10.1093/her/cyl148. View

11.

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

12.

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

13.

Shearin E, Russ M, Hull J, Clarkin J, Smith G . Construct validity of the Three-Factor Eating Questionnaire: flexible and rigid control subscales. Int J Eat Disord. 1994; 16(2):187-98. DOI: 10.1002/1098-108x(199409)16:2<187::aid-eat2260160210>3.0.co;2-u. View

14.

Forman E, Herbert J, Moitra E, Yeomans P, Geller P . A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression. Behav Modif. 2007; 31(6):772-99. DOI: 10.1177/0145445507302202. View

15.

Weinsier R, Nagy T, Hunter G, Darnell B, Hensrud D, Weiss H . Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the set-point theory. Am J Clin Nutr. 2000; 72(5):1088-94. DOI: 10.1093/ajcn/72.5.1088. View

16.

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

17.

Forman E, Hoffman K, Juarascio A, Butryn M, Herbert J . Comparison of acceptance-based and standard cognitive-based coping strategies for craving sweets in overweight and obese women. Eat Behav. 2012; 14(1):64-8. DOI: 10.1016/j.eatbeh.2012.10.016. View

18.

Webber K, Tate D, Ward D, Bowling J . Motivation and its relationship to adherence to self-monitoring and weight loss in a 16-week Internet behavioral weight loss intervention. J Nutr Educ Behav. 2010; 42(3):161-7. DOI: 10.1016/j.jneb.2009.03.001. View

19.

Yeomans M, Leitch M, Mobini S . Impulsivity is associated with the disinhibition but not restraint factor from the Three Factor Eating Questionnaire. Appetite. 2007; 50(2-3):469-76. DOI: 10.1016/j.appet.2007.10.002. View

20.

Lowe M . Self-regulation of energy intake in the prevention and treatment of obesity: is it feasible?. Obes Res. 2003; 11 Suppl:44S-59S. DOI: 10.1038/oby.2003.223. View