Acceptance-based versus standard behavioral treatment for obesity: Results from the mind your health randomized controlled trial.
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.
Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA. evan.forman@drexel.edu.
Evan M
EM
Forman
Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA.
Meghan L
ML
Butryn
Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA.
Stephanie M
SM
Manasse
Neuropsychiatric Research Institute, Fargo, North Dakota, USA.|Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA.
Ross D
RD
Crosby
Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA.
Stephanie P
SP
Goldstein
Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA.
Emily P
EP
Wyckoff
Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
J Graham
JG
Thomas
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology* / Q000628:therapy*; D050177:Overweight / Q000628:therapy; D057181:Pleasure; D020377:Self Efficacy; D016896:Treatment Outcome; D015431:Weight Loss
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