Psychological Intervention to Reduce Weight Bias Internalization
Condition: Stigmatization; Obesity; Weight Loss
MeSH terms: Body Weight; Weight Loss
Study type: Interventional

Summary: 
      This is a randomized controlled trial to test the effects on WBI of a novel psychological
      intervention combined with standard behavioral weight loss (BWL) treatment, as compared to
      BWL alone. Participants will be a total of 72 men and women seeking weight loss, ages 18-65
      years, with a body mass index (BMI) of 30 kg/m2 or above, a history of experiencing weight
      bias, and elevated levels of WBI. Participants will attend a screening visit in which they
      will complete a behavioral evaluation with a psychologist and a medical history that will be
      reviewed by a nurse practitioner or physician. Questionnaires assessing experiences and
      internalization of weight bias, with confirmation by interviewer assessment during the
      behavioral evaluation, will be used to determine whether participants meet criteria for
      having high levels of WBI. Eligible consenting participants will be randomly assigned to the
      standard BWL intervention (n = 36) or the BWL + BIAS program (n = 36). All participants will
      attend weekly, 90-minute group meetings for 12 weeks (12 visits). In the BWL + stigma
      intervention, 60 minutes will be devoted to BWL and 30 minutes to weight stigma. In the
      standard BWL treatment group, the additional 30 minutes will be devoted to sharing recipes
      and food preparation tips. Following 12 weeks of weight loss treatment, participants will
      attend group meetings focused on weight loss maintenance, every-other-week from weeks 13-16
      (2 visits), and monthly from weeks 17-26 (2 visits). Maintenance sessions in the BWL + stigma
      group will continue to incorporate discussion of WBI. Assessments - which include
      questionnaires and measurements of body weight - will occur at baseline and weeks 12 and 26.
      Weight will be measured at every group meeting for clinical purposes.
    


Intervention name(s): BWL; BIAS
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The BWL sessions will be based on the Diabetes Prevention Program (DPP) manual. A diet of 1200-1499 calories per day will be prescribed for participants < 250 lb, and 1500-1800 for those ≥ 250 lb. Participants will be instructed to eat a balanced deficit diet. Session topics during the first 12 weeks will include self-monitoring, stimulus control, slowing eating, social support, cognitive restructuring, portion sizes, and goal-setting. Those during weeks 13-26 will focus on continued self-monitoring and skills required for weight loss maintenance and relapse prevention. Physical activity will be prescribed at a level consistent with data showing that >250 min/wk is associated with improved long-term weight loss. BWL sessions will last 60 minutes.; Following 60 minutes of BWL treatment, the BIAS intervention will devote 30 minutes to stigma-related content. Session topics will include: psychoeducation about weight and weight stigma; challenging myths and cognitive distortions related to weight; strategies for coping with instances of stigma; and increasing empowerment and body esteem. The effects of weight stigma on health behaviors will be discussed, and sessions will focus specifically on helping participants overcome stigma-related barriers to weight management. In the every-other-week and monthly weight loss maintenance sessions from weeks 13-26, strategies for coping with weight stigma and challenging internalized beliefs will be reviewed, and participants will be encouraged to use these strategies in the context of weight management.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment