In the Journals

Weight loss, quality of life enhanced by acceptance-based behavioral therapy

Acceptance-based behavioral treatment for weight loss in adults with obesity improved the success rate of sustaining long-term weight loss and quality of life compared with standard treatment, according to findings published in Obesity.

Evan M. Forman

“Lifestyle modification and weight loss are extremely difficult; almost no one can succeed without structured behavioral treatment,” Evan M. Forman, PhD, professor of psychology at Drexel University in Philadelphia, told Endocrine Today.

The findings of the researchers are based on a follow-up to the Mind Your Health study, which was a randomized controlled trial comparing acceptance-based behavioral therapy and standard behavioral therapy in 190 adults with overweight or obesity (mean age, 51.6 years; 82.1% women). Participants were recruited in Philadelphia and randomly assigned to acceptance or standard therapy for 12 months. The current study by Forman and colleagues examined results in the 2 years after the initial trial.

Participants in both groups took part in 25 closed-group sessions during the trial period and were assigned the same diet and physical activity goals. Those in the standard group were taught behavioral skills, the cognitive behavior model, cognitive restructuring and coping techniques during the trial. In the acceptance group, in addition to a personalized set of goals, participants were taught about accepting “reduced pleasure” during weight loss and an understanding of the internal and external influences on eating and exercise and what can be controlled.

At 24 months and 36 months, participants were weighed, and psychological acceptance, mood disturbance and quality of life were assessed via questionnaires.

The researchers found that participants in the acceptance group had more weight loss at 24 months (7.5% vs. 5.6%; P = .15) and at 36 months (4.7% vs. 3.3%; P = .31) vs. the standard group. In addition, the researchers observed that 10% weight loss at 36 months was more frequent in the acceptance group compared with the standard group (25% vs. 14.4%; P = .07). This result was particularly significant for participants who were considered trial completers (P = .04).

Acceptance-based therapy also led to improvements in quality-of-life assessments at 24 months (P < .01) and 36 months (P = .02) compared with standard therapy. When the researchers controlled for weight loss, quality-of-life measures at 24 months (P = .01) and 36 months (P = .03) were still superior for the acceptance group compared with the standard group.

“Notably, differences existed above and beyond weight loss, suggesting that [acceptance-based therapy] had direct effects on quality of life in excess of those of [standard behavior therapy],” the researchers wrote. “Perhaps [acceptance-based therapy’s] focus on living out life values regardless of one’s internal experiences produced better quality of life relative to [standard behavior therapy].” – by Phil Neuffer

Disclosures: Forman reports he received royalties from Oxford Press for two workbooks describing acceptance-based behavioral treatment. Please see the study for all other authors’ relevant financial disclosures.

Acceptance-based behavioral treatment for weight loss in adults with obesity improved the success rate of sustaining long-term weight loss and quality of life compared with standard treatment, according to findings published in Obesity.

Evan M. Forman

“Lifestyle modification and weight loss are extremely difficult; almost no one can succeed without structured behavioral treatment,” Evan M. Forman, PhD, professor of psychology at Drexel University in Philadelphia, told Endocrine Today.

The findings of the researchers are based on a follow-up to the Mind Your Health study, which was a randomized controlled trial comparing acceptance-based behavioral therapy and standard behavioral therapy in 190 adults with overweight or obesity (mean age, 51.6 years; 82.1% women). Participants were recruited in Philadelphia and randomly assigned to acceptance or standard therapy for 12 months. The current study by Forman and colleagues examined results in the 2 years after the initial trial.

Participants in both groups took part in 25 closed-group sessions during the trial period and were assigned the same diet and physical activity goals. Those in the standard group were taught behavioral skills, the cognitive behavior model, cognitive restructuring and coping techniques during the trial. In the acceptance group, in addition to a personalized set of goals, participants were taught about accepting “reduced pleasure” during weight loss and an understanding of the internal and external influences on eating and exercise and what can be controlled.

At 24 months and 36 months, participants were weighed, and psychological acceptance, mood disturbance and quality of life were assessed via questionnaires.

The researchers found that participants in the acceptance group had more weight loss at 24 months (7.5% vs. 5.6%; P = .15) and at 36 months (4.7% vs. 3.3%; P = .31) vs. the standard group. In addition, the researchers observed that 10% weight loss at 36 months was more frequent in the acceptance group compared with the standard group (25% vs. 14.4%; P = .07). This result was particularly significant for participants who were considered trial completers (P = .04).

Acceptance-based therapy also led to improvements in quality-of-life assessments at 24 months (P < .01) and 36 months (P = .02) compared with standard therapy. When the researchers controlled for weight loss, quality-of-life measures at 24 months (P = .01) and 36 months (P = .03) were still superior for the acceptance group compared with the standard group.

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“Notably, differences existed above and beyond weight loss, suggesting that [acceptance-based therapy] had direct effects on quality of life in excess of those of [standard behavior therapy],” the researchers wrote. “Perhaps [acceptance-based therapy’s] focus on living out life values regardless of one’s internal experiences produced better quality of life relative to [standard behavior therapy].” – by Phil Neuffer

Disclosures: Forman reports he received royalties from Oxford Press for two workbooks describing acceptance-based behavioral treatment. Please see the study for all other authors’ relevant financial disclosures.