Category: Treatment - ACT

Symposium

Effects of Acceptance-Based Versus Standard Behavioral Treatment for Obesity: Effects on Weight loss, Behavior, Quality of Life, and Depression

Friday, November 17
8:30 AM - 10:00 AM
Location: Sapphire Ballroom A, Level 4, Sapphire Level

Keywords: Acceptance | Obesity / Overweight | Experiential Avoidance
Presentation Type: Symposium

Acceptance-based behavioral treatments (ABTs; i.e., approaches that fuse behavioral strategies with tolerance of difficult internal experiences and loss of pleasure, mindful decision making and commitment to valued behavior) have been recognized as potential enhancements to the efficacy of gold standard behavior treatment (SBT) for weight loss. However, only one full randomized controlled trial testing this hypothesis has been published to date, and no long-term follow-up has been conducted.  The NIH-funded Mind Your Health Project randomly assigned overweight and obese participants (n = 190) to 25 sessions of either SBT or ABT.  At the 1-year (post-treatment) and 2-year (1-year follow-up) assessments, and using maximum likelihood imputation, ABT produced significantly greater percent weight loss (1-year: 13.3% ± 0.83, 2-year: 7.3% ± 0.88) than did SBT (1-year: 9.8% ± 0.87, 2-year: 4.6% ± 0.92; linear effect of treatment condition p = .04).   The amount of moderate-to-vigorous physical activity increased over time, though this improvement was equivalent by treatment group. Quality of life improved at faster rates (p = .02) and was was better sustained in the ABT compared to SBT group (p =.01), and this difference remained significant at the trend level (p = .06) even when controlling for weight losses. However, depression improved through time equivalently in each treatment condition. In terms of process variables, the two groups were equivalent in improvements in mindfulness, distress tolerance, and experiential acceptance through time. Of note, improvements in eating-related experiential acceptance were greater in ABT and changes in this variable mediated the effect of treatment condition on weight loss at post-treatment.  Overall, results suggest that infusing standard behavioral treatment for weight loss with acceptance-based strategies enhances weight loss (presumably through improved adherence to a lower-calorie diet, which is difficult to measure) and quality of life, but that most other outcomes are equivalently improved by both treatments.

Evan Forman

Professor
Drexel University

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