Abstract

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 #NCT02156752https://www.clinicaltrials.gov/ct2/show/NCT02156752.

中文翻译：

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改善长期减肥的新型行为干预措施：一项关于接受和承诺疗法或自我调节以维持减肥的随机试验

摘要

维持体重减轻很难实现，需要新的干预措施来改善长期结果。在这项随机对照试验中，N = 188 名参与者接受了为期 12 周的在线减肥干预，N = 102 名体重减轻 ≥ 5% 的参与者随后被随机分配到基于接受和承诺疗法的 1 天 5 小时研讨会(ACT)、自律 (SR) 或没有研讨会（控制），并有 3 个月的有限电子邮件跟进。在基线、3、6、12、18 和 24 个月时进行了评估。主要结果是体重变化百分比；次要结果是体重相关的经验回避和健康价值观一致的行为。与对照组（-1.15%，SE = 1.50；p = .03）。事后分析表明， 在初始体重减轻较低 (5-7%) 的患者中，ACT 的体重减轻明显大于对照组 (6.11%，β = -2.03 ，p = .048)，并且体重减轻明显大于 SR (6.19 %, β = -1.77, p  = .05) 在初始重量损失最高 (10% +) 的人群中。有可能继续以有限的干预者接触形式发展 ACT，并进行修改。这项试点研究代表了一种创新的行为减肥模型，它通过逆转典型的治疗强度模型，目的是在初始减肥后的关键时期提供干预支持。

登记

Clinicaltrials.org #NCT02156752https://www.clinicaltrials.gov/ct2/show/NCT02156752。