A randomized trial of an acceptance-based behavioral intervention for weight loss in people with high internal disinhibition

Jason Lillis, Heather M Niemeier, J Graham Thomas, Jessica Unick, Kathryn M Ross, Tricia M Leahey, Kathleen E Kendra, Leah Dorfman, Rena R Wing, Jason Lillis, Heather M Niemeier, J Graham Thomas, Jessica Unick, Kathryn M Ross, Tricia M Leahey, Kathleen E Kendra, Leah Dorfman, Rena R Wing

Abstract

Objective: To determine whether an acceptance-based behavioral intervention (ABBI) produces better weight losses than standard behavioral treatment (SBT) among individuals reporting high internal disinhibition.

Methods: Participants were 162 adults with overweight or obesity (mean BMI 37.6 kg/m2 ) randomly assigned to ABBI or SBT. Both interventions provided the same calorie intake target, exercise goal, and self-monitoring skills training. SBT incorporated current best practice interventions for addressing problematic thoughts and emotions. ABBI utilized acceptance-based techniques based on Acceptance and Commitment Therapy. ABBI and SBT were compared on weight change and internal disinhibition change over 24 months.

Results: Mixed models analysis showed mean weight loss at 24 months was -4.1% (SE = 0.88) for ABBI and -2.4% (SE = 0.87) for SBT (P = 0.204). Secondary analyses showed that the ABBI group regained less weight from the end of treatment to the final follow-up (4.6 vs. 7.1 kg; P = 0.005), and that a significantly higher proportion of ABBI participants achieved a 5% weight loss (38% vs. 25%; P = 0.038) at 24 months.

Conclusions: Results suggest that ABBI could be helpful for improving the maintenance of weight loss for individuals who report high internal disinhibition.

Conflict of interest statement

The authors declare that they have no conflict of interest.

© 2016 The Obesity Society.

Figures

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Figure 1
Participant Flow

References

    1. MacLean PS, Wing RR, Davidson T, et al. NIH Working Group Report: Innovative Research to Improve Maintenance of Weight Loss. Obesity. 2015;23:7–15.
    1. Butryn ML, Webb V, Wadden TA. Behavioral Treatment of Obesity. Psychiatric Clinics of North America. 2011;34:841–+.
    1. Loveman E, Frampton GK, Shepherd J, et al. The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review. Health Technology Assessment. 2011;15:1–+.
    1. Jeffery RW, Drewnowski A, Epstein LH, et al. Long-term maintenance of weight loss: Current status. Health Psychology. 2000;19:5–16.
    1. Perri MG. The maintenance of treatment effects in the long-term management of obesity. Clinical Psychology-Science and Practice. 1998;5:526–43.
    1. Barte JCM, ter Bogt NCW, Bogers RP, et al. Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review. Obesity Reviews. 2010;11:899–906.
    1. Jakicic J, Wing R, Winters C. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women. Journal of the American Medical Association. 1999;282:1554–60.
    1. Wadden T, Stunkard A, Liebschutz J. Three year follow-up of the treatment of obesity by very-low-calorie diet, behavior therapy, and their combination. Journal of Consulting and Clinical Psychology. 1988;56:925–8.
    1. Middleton KMR, Patidar SM, Perri MG. The impact of extended care on the long-term maintenance of weight loss: a systematic review and meta-analysis. Obesity Reviews. 2012;13:509–17.
    1. Wang J, Sereika SM, Chasens ER, Ewing LJ, Matthews JT, Burke LE. Effect of adherence to self-monitoring of diet and physical activity on weight loss in a technology-supported behavioral intervention. Patient Preference and Adherence. 2012;6:221–6.
    1. Murphy JK, Williamson DA, Buxton AE, Moody SC, Absher N, Warner M. The long-term effects of spouse involvement upon weight loss and maintenance. Behavrio Therapy. 1982;13:681–93.
    1. Volpp KG, John LK, Troxel AB, Norton L, Fassbender J, Loewenstein G. Financial Incentive-Based Approaches for Weight Loss A Randomized Trial. Jama-Journal of the American Medical Association. 2008;300:2631–7.
    1. Diabetes Prevention Program Research Group. The Diabetes Prevention Program: Description of the Lifestyle Intervention. Diabetes care. 2002;25:2165–71.
    1. Hayes SC, Strosahl K, Wilson KG, et al. Measuring experiential avoidance: A preliminary test of a working model. Psychological Record. 2004;54:553–78.
    1. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy. 2006;44:1–25.
    1. Forman EM, Hoffman KL, McGrath KB, Herbert JD, Brandsma LL, Lowe MR. A comparison of acceptance- and control-based strategies for coping with food cravings: an analog study. Behav Res Ther. 2007;45:2372–86.
    1. Hoffman KL, Forman EM, Herbert JD, et al. Comparison of acceptance-based and standard cognitive-based coping strategies for craving sweets in overweight and obese women. In: Herbert (Chair) J, editor. Cognitive Reappraisal vs Experiential Acceptance; 43rd Annual Convention of the Association for Behavioral and Cognitive Therapies; New York, NY. 2009.
    1. Hayes SC, Strosahl K, Wilson KG. Acceptance and Commitment Therapy: An experiential approach to behavior change. New York: The Guilford Press; 1999.
    1. Lillis J, Hayes SC, Levin ME. Binge Eating and Weight Control: The Role of Experiential Avoidance. Behavior Modification. 2011;35:252–64.
    1. Hooper N, Sandoz EK, Ashton J, Clarke A, McHugh L. Comparing thought suppression and acceptance as coping techniques for food cravings. Eating Behaviors. 2012;13:62–4.
    1. Gregg JA, Callaghan GA, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. Journal of Consulting and Clinical Psychology. 2007;75:336–43.
    1. Forman EM, Butryn ML, Hoffman KL, Herbert JD. An open trial of an acceptance-based behavioral intervention for weight loss. Cognitive and Behavioral Practice. 2009;16:223–35.
    1. Tapper K, Shaw C, Ilsley J, Hill AJ, Bond FW, Moore L. Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite. 2009;52:396–404.
    1. Goodwin CL, Forman EM, Herbert JD, Butryn ML, Ledley GS. A Pilot Study Examining the Initial Effectiveness of a Brief Acceptance-Based Behavior Therapy for Modifying Diet and Physical Activity Among Cardiac Patients. Behavior Modification. 2012;36:199–217.
    1. Lillis J, Hayes SC, Bunting K, Masuda A. Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model. Annals of Behavioral Medicine. 2009;37:58–69.
    1. Forman EM, Butryn ML, Juarascio AS, et al. The Mind Your Health Project: A Randomized Controlled Trial of an Innovative Behavioral Treatment for Obesity. Obesity. 2013;21:1119–26.
    1. Niemeier HM, Phelan S, Fava JL, Wing RR. Internal disinhibition predicts weight regain following weight loss and weight loss maintenance. Obesity. 2007;15:2485–94.
    1. Stunkard AJ, Messick S. The 3-Factor Eating Questionnaire to Measure Dietary Restraint, Disinhibition and Hunger. Journal of Psychosomatic Research. 1985;29:71–83.
    1. Butryn ML, Thomas JG, Lowe MR. Reductions in Internal Disinhibition During Weight Loss Predict Better Weight Loss Maintenance. Obesity. 2009;17:1101–3.
    1. Niemeier HM, Leahey T, Reed KP, Brown RA, Wing RR. An Acceptance-Based Behavioral Intervention for Weight Loss: A Pilot Study. Behavior Therapy. 2012;43:427–35.
    1. Lillis J, Niemeier HM, Ross KM, et al. Weight loss intervention for individuals with high internal disinhibition: Design of the Acceptance BAsed Behavioral INtervention (ABBI) randomized controlled trial. BMC Psychology. in press.
    1. Wing RR, Phelan S. Behavioral treatment of obesity: strategies to improve outcome and predictors of success. In: Eckel RH, editor. Obesity: An Academic Basis for Clinical Evaluation and Treatment. Lippincott: Williams & Wilkens; 2002. pp. 415–35.
    1. Wing RR, Papandonatos G, Fava JL, et al. Maintaining large weight losses: the role of behavioral and psychological factors. J Consult Clin Psychol. 2008;76:1015–21.
    1. Gifford EV, Kohlenberg BS, Hayes SC, et al. Acceptance-based treatment for smoking cessation. Behavior Therapy. 2004;35:689–705.

Source: PubMed

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