Acceptance based behavioral intervention for weight loss: A randomized trial

基于接受的减肥行为干预：一项随机试验

• 批准号: 8255443
• 负责人: Rena R Wing
• 金额: $ 53.68万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-15 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8255443
• 关键词: Adherence; Adult; Affect; Behavior Therapy; Behavioral; Binge eating disorder; Body Weight decreased; Cognitive; Cues; Development; Diet; Disinhibition; Eating; Educational process of instructing; Emotional; Emotions; Equipment and supply inventories; Feeling; Goals; Health; Hyperphagia; Individual; Mediating; Mental Health; Mild obesity; Monitor; Obesity; Outcome; Overweight; Participant; Patients; Physical activity; Pilot Projects; Population; Problem behavior; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Subgroup; Techniques; Testing; Thinking; Treatment outcome; Weight; Weight maintenance regimen; Weights and Measures; base; distraction; distress tolerance; effective therapy; emotion regulation; experience; help-seeking behavior; improved; innovation; intervention program; meetings; moderate obesity; novel strategies; programs; public health relevance; randomized trial; response; skills; standard care; stressor; therapy development; treatment adherence; treatment program; trial comparing; weight loss intervention; weight maintenance

DESCRIPTION (provided by applicant): Obesity is a major health problem, affecting over one-third of US adults. Behavioral weight control programs are the treatment of choice for mild and moderate obesity, but there is marked variability among patients in the weight losses achieved and the maximum weight losses are usually achieved by month 6, followed by weight regain. Both of these problems might be improved by a more specialized approach for the sub-group of obese patients who report a tendency to overeat in response to emotional and/or cognitive stressors, referred to as internal disinhibition. Recent studies show that approximately 50% of individuals entering behavioral weight loss programs report problems with internal disinhibition and that these individuals lose significantly less weight, particularly at 18 months, than other participants in standard behavioral weight loss programs. We hypothesize that these individuals might achieve better weight loss outcomes in a behavioral weight loss program that focuses on acceptance-based strategies rather than in a standard weight loss program. Acceptance based approaches 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 these negative thoughts and feelings, whereas standard behavioral programs teach patients to control their negative thoughts with techniques such as cognitive restructuring and distraction. Acceptance based approaches have yielded positive results for a variety of psychological and health conditions. In a pilot study we conducted, we obtained impressive results using an acceptance based behavioral intervention for obese patients who reported problems dealing with negative internal cues. We propose to conduct a randomized controlled trial comparing a standard behavioral weight loss treatment program (SBT) with an innovative approach that combines standard behavioral weight loss with an acceptance based behavioral intervention (ABBI). We will recruit 160 overweight/obese patients who report high internal disinhibition, and thus would be likely to benefit most from this novel approach to emotion regulation. These participants will be randomly assigned to 18 months of either SBT or ABBI with full assessments at baseline, 6, 12, and 18 months. The primary hypothesis is that participants in the ABBI program will achieve better weight losses than SBT at 6, 12, and 18 months. Secondary hypotheses are that participants in the ABBI program will report greater acceptance of negative thoughts and emotions and greater distress tolerance and will have better treatment adherence than participants in SBT, and that differences in acceptance of negative thoughts and emotions will mediate the differences in weight loss between the groups. This project uses an innovative approach to the treatment of obese individuals who report problems with internal disinhibition. Development of an approach that improves weight loss outcomes would provide a tremendous benefit to the field of obesity. PUBLIC HEALTH RELEVANCE: Obesity is a major health problem affecting over one third of US adults. Approximately half of the obese patients seeking help with weight control report problems dealing with negative thoughts and emotions and these individuals appear to do less well in standard treatment approaches. By incorporating strategies from a new treatment approach, in which patients are taught to accept these negative thoughts, rather than trying to change them, we may be able to improve the weight losses achieved by these obese patients.

描述（由申请人提供）：肥胖是一个主要的健康问题，影响了我们三分之一的成年人。行为体重控制程序是轻度和中度肥胖症的选择治疗，但是体重减轻的患者之间的可变性明显明显，通常在第6个月之前实现最大的体重减轻，然后重新获得体重。对于肥胖患者的子群体，这些方法可能会改善这两个问题，这些肥胖患者报告说，他们响应于情绪和/或认知压力源（称为内部抑制作用）而过高的趋势。最近的研究表明，与标准行为减肥计划中的其他参与者相比，大约有50％的人进入行为减肥计划的个人报告了内部抑制的问题，尤其是在18个月时，这些人的体重显着少得多。我们假设这些人可能会在行为减肥计划中获得更好的减肥结果，该计划的重点是基于接受的策略而不是标准减肥计划。基于验收的方法教患者在不尝试控制它们并继续追求其行为目标的情况下经历了这些负面的思想和感受，而没有试图继续追求他们的思想和感受，而标准行为计划会教患者通过认知重组和分散注意力等技术来控制他们的负面思想。基于接受的方法为多种心理和健康状况产生了积极的结果。在我们进行的一项试点研究中，我们使用基于验收的行为干预措施为报道遇到负面内部提示问题的肥胖患者获得了令人印象深刻的结果。 我们建议进行一项随机对照试验，将标准行为减肥治疗计划（SBT）与创新的方法进行比较，该方法将标准行为减肥与基于接受性行为干预（ABBI）相结合。我们将招募160名报告高度抑制作用的超重/肥胖患者，因此可能会从这种新颖的情绪调节方法中受益最大。这些参与者将在基线，6、12和18个月时随机分配到SBT或ABBI的18个月的SBT或ABBI。主要假设是，ABBI计划的参与者将在6、12和18个月的时间内实现比SBT更好的体重减轻。次要假设是，ABBI计划的参与者将报告对负面思想和情绪和更大的痛苦承受能力的接受程度比SBT的参与者更好，并且具有更好的治疗依从性，并且对负面思想和情感的接受程度差异将介导群体之间的体重损失差异。 该项目使用一种创新的方法来治疗报告内部抑制问题的肥胖个体。改善减肥结果的方法的发展将为肥胖领域带来巨大的好处。 公共卫生相关性：肥胖是影响我们三分之一成年人的主要健康问题。在寻求体重控制方面，大约一半的肥胖患者报告了处理负面思想和情绪的问题，这些人在标准治疗方法中似乎做得不太好。通过从一种新的治疗方法中纳入策略，其中教导患者接受这些负面想法，而不是试图改变它们，我们可能能够改善这些肥胖患者实现的体重减轻。