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

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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.

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

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Funding

This study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (K23DK097143).

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Authors and Affiliations

  1. Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, RI, 20903, USA

    J. Lillis, J. G. Thomas & R. R. Wing

  2. Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI, USA

    S. Dunsiger

  3. Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA

    K. M. Ross

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  1. J. Lillis
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  2. S. Dunsiger
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  3. J. G. Thomas
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  4. K. M. Ross
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  5. R. R. Wing
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Correspondence to J. Lillis.

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This study was approved by the Miriam Hospital IRB in Providence, RI, USA. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Lillis, J., Dunsiger, S., Thomas, J.G. et al. Novel behavioral interventions to improve long-term weight loss: A randomized trial of acceptance and commitment therapy or self-regulation for weight loss maintenance. J Behav Med 44, 527–540 (2021). https://doi.org/10.1007/s10865-021-00215-z

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