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: 8104914
• 负责人: Rena R Wing
• 金额: $ 50.83万
• 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/8104914
• 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; 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，影响着超过三分之一的美国成年人。行为体重控制计划是轻度和中度肥胖症的治疗选择，但在患者中实现的体重减轻存在显著差异，并且通常在第6个月达到最大体重减轻，随后体重恢复。这两个问题可能会得到改善，一个更专门的方法，为亚组的肥胖患者谁报告的倾向，暴饮暴食，以回应情绪和/或认知压力，称为内部去抑制。最近的研究表明，大约50%的人进入行为减肥计划报告的问题与内部去抑制，这些人失去了显着更少的重量，特别是在18个月，比其他参与者在标准的行为减肥计划。我们假设，这些人可能会实现更好的减肥结果，在行为减肥计划，重点是接受为基础的战略，而不是在一个标准的减肥计划。基于接受的方法教导患者体验思想和感受，而不是试图控制它们，并继续追求他们的行为目标，尽管经历了这些消极的思想和感受，而标准的行为程序教导患者通过认知重建和分散注意力等技术来控制他们的消极思想。接受为基础的方法产生了积极的结果，为各种心理和健康状况。在我们进行的一项试点研究中，我们对肥胖患者进行了基于接受的行为干预，这些患者报告了处理负面内部线索的问题，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，比较标准行为减肥治疗计划（SBT）与将标准行为减肥与基于接受的行为干预（ABBI）相结合的创新方法。我们将招募160名超重/肥胖患者，他们报告了高内部去抑制，因此可能从这种新的情绪调节方法中获益最多。这些受试者将被随机分配到18个月的SBT或ABBI，并在基线、6、12和18个月进行全面评估。主要假设是ABBI计划的参与者在6个月，12个月和18个月时的体重减轻效果优于SBT。次要假设是，ABBI计划的参与者将报告更大的接受消极思想和情绪，更大的痛苦容忍度，并将有更好的治疗依从性比SBT的参与者，以及接受消极思想和情绪的差异将介导组间减肥的差异。 该项目采用了一种创新的方法来治疗肥胖的个人谁报告的问题与内部去抑制。开发一种改善减肥结果的方法将为肥胖领域提供巨大的益处。 公共卫生相关性：肥胖是影响超过三分之一美国成年人的主要健康问题。大约一半寻求体重控制帮助的肥胖患者报告了处理消极思想和情绪的问题，这些人在标准治疗方法中似乎做得不太好。通过结合新的治疗方法的策略，即教导患者接受这些消极的想法，而不是试图改变它们，我们可能能够改善这些肥胖患者的体重减轻。