Novel behavioral interventions to improve long-term weight loss: A randomized trial of acceptance and commitment therapy or self-regulation for weight loss maintenance

• Published in: Journal of behavioral medicine Vol. 44; no. 4; pp. 527 - 540
• Main Authors: Lillis, J., Dunsiger, S., Thomas, J. G., Ross, K. M., Wing, R. R.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-08-2021; Springer; Springer Nature B.V
• Subjects: Acceptance; Acceptance and commitment therapy; Avoidance behavior; Behavior modification; Body weight loss; Clinical trials; Email; Family Medicine; General Practice; Health aspects; Health behavior; Health Psychology; Intervention; Medicine; Medicine & Public Health; Methods; Obesity; Psychological aspects; Public health; Self regulation; Self-control; Testing; Weight control; Weight loss; Weight loss maintenance; United States; Obesity; Acceptance; Maintenance; Weight loss; Self-regulation
• ISSN: 0160-7715; 1573-3521
• DOI: 10.1007/s10865-021-00215-z

Maintenance of weight loss is hard to achieve, and novel interventions are needed to improve long-term outcomes. In this pilot randomized controlled trial, N = 188 participants received an online, 12-week weight loss intervention and N = 102 who lost ≥ 5% were then randomly assigned to a 1-day, 5-h workshop based on Acceptance and Commitment Therapy (ACT), Self-Regulation (SR), or no workshop (Control) with 3 months of limited email follow-up. Assessments were conducted at baseline, 3, 6, 12, 18, and 24 months. The primary outcome was percent weight change; secondary outcomes were weight-related experiential avoidance and health values-consistent behavior. ACT had greater overall weight loss (−7.18%, SE = 1.33) when compared to Control (−1.15%, SE = 1.50;
p
 = .03). Post hoc analyses showed that ACT had significantly greater weight losses than Control (6.11%, β = −2.03,
p
 = .048) among those with lower initial weight loss (5–7%), and significantly greater weight loss than SR (6.19%, β = −1.77,
p
 = .05) among those with the highest initial weight losses (10% +). There is potential for continuing to develop ACT in a limited interventionist-contact format with modifications. This pilot study represents an innovative model for behavioral weight loss by reversing the typical treatment intensity model with the aim of providing interventionist support during a critical period after initial weight loss.
Registration
Clinicaltrials.org #NCT02156752
https://www.clinicaltrials.gov/ct2/show/NCT02156752
.