Acceptance Based Behavioral Intervention for Weight Loss: A Randomized Trial
Condition: Obesity
MeSH terms: Weight Loss
Study type: Interventional

Summary: 
      The proposed project is testing two behavioral interventions designed to improve long-term
      weight loss among participants who struggle with eating in response to stress or emotional
      experiences. Group treatment lasts for 1 year, with assessments lasting 2 years. Participants
      must live in the greater Providence, Rhode Island area in order to be eligible.
    

Detailed description: 
      Obesity is a major health problem and behavioral weight control programs are the treatment of
      choice for mild and moderate obesity. However, there is marked variability among participants
      in the weight losses achieved in these programs and the maximum weight losses are typically
      achieved at month 6, followed by weight regain. Thus innovative approaches are needed to
      improve longer-term treatment outcomes.

      Currently, the same behavioral treatment program is offered to all participants, with no
      tailoring to meet the needs of specific subgroups. One subgroup that may need a specialized
      approach are those who report high levels of internal disinhibition, i.e. eating in response
      to negative thoughts or emotions. Over 50% of individuals entering behavioral weight loss
      programs report high levels of internal disinhibition on the Eating Inventory (EI), this
      subgroup is distinct from those with binge eating disorder, and most importantly, these
      individuals lose significantly less weight than other participants during weight loss
      treatment [particularly at 18 months]. Thus efforts are needed to develop more effective
      treatments for this subgroup. The proposed research is significant because it may help move
      the field from a "one size fits all" approach, to the development of interventions for
      specific subgroups of the population.

      The investigators hypothesize that individuals who report problems with internal
      disinhibition may achieve better weight losses in an enhanced behavioral weight loss program
      that focuses on acceptance-based strategies. Whereas standard behavioral treatments teach
      patients to control their negative thoughts with techniques such as cognitive restructuring
      and distraction, acceptance based strategies teach patients to experience thoughts and
      feelings as they are, without attempting to control them and to continue to pursue their
      behavioral goals despite experiencing negative thoughts and feelings. Acceptance-based
      strategies have been shown to be helpful for a number of behavioral problems including weight
      loss and maintenance, however are yet untested in large trials.

      The current study is a randomized controlled trial comparing standard behavioral weight loss
      treatment with a program which incorporates acceptance based strategies in the treatment of
      overweight/obese individuals with problems with internal disinhibition. A total of 160
      participants will be randomly assigned to a standard behavioral weight loss treatment program
      (SBT) or to an innovative approach that combines standard behavioral weight loss with
      acceptance based strategies (referred to hereafter as "Acceptance Based Behavioral
      Intervention" or ABBI). Both groups will meet weekly for 6 months, biweekly for 3 months and
      then monthly for 3 months. Assessments will be conducted at baseline and 6 month intervals
      for 24 months total, with measures of weight, acceptance of negative emotions, distress
      tolerance, and adherence to the weight loss program.

      The primary hypothesis is that participants in the ABBI program will achieve greater changes
      in weight (in the form of weight reductions) at 6, 12, 18, and 24 months when compared to
      baseline weight than participants in SBT. Secondary hypotheses are that participants in ABBI
      will experience greater improvements in acceptance of weight related negative thoughts and
      emotions and distress tolerance and better treatment adherence than participants in SBT.
    

Intervention name(s): Nutrition Education; Behavioral Weight Loss Strategies; Standard Cognitive Techniques; Acceptance Based Techniques
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): Participants are taught about energy balance, caloric intake, the nutrition content of foods, and diet.; Participants are taught self-monitoring and goal setting techniques.; Participants are taught how to modify, get rid of, or distract from thoughts and also how to regulate emotions.; Participants are taught how to accept and change their perception of their thoughts and emotions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Obesity; Primary Care; Behavior Modification