Acceptance-based behavior treatment: An innovative weight control intervention

描述（由申请人提供）：美国正处于肥胖的流行之中，迫切需要创新的方法来解决这个问题。虽然传统的行为疗法是最经经验验证的减肥方法，但它通常会导致体重控制行为的维持不佳，并且在三到五年内，这些项目的大多数参与者都会恢复到原来减掉的体重。标准的行为减肥治疗可以通过纳入以下组成部分来改进：(a)加强参与者对行为改变的承诺，(b)建立痛苦耐受技能，(c)促进对饮食行为和目标的有意识意识。这些成分在行为治疗的新模型中得到了很好的体现，这些模型结合了正念、经验意识、改变行为的价值观、接受痛苦的内在体验以及在有价值的行为改变中愿意忍受痛苦的原则和技术。该项目的主要目标是确定一个创新的行为减肥计划，结合行为治疗领域的新发展，是否比标准行为治疗产生更好的体重控制。将通过媒体广告在大费城社区招募128名体重指数为27至40 kg/m2的成年人参与本研究。参与者将被随机分配到两种情况之一：标准行为治疗（SBT）或基于接受的行为治疗（ABBT）。每项治疗将以小组形式每周进行一次，然后是每两周进行一次。治疗将持续40周：第1-20周的重点是减肥，而第21-40周的部分重点是维持减肥效果。评估将在基线、10周、20周（即减肥治疗结束）、40周（即减肥维持治疗结束）和6个月随访时完成。公共卫生相关性：肥胖正达到流行病的程度。肥胖的标准行为治疗有效地诱导体重减轻，但长期维持体重减轻仍然具有挑战性。本研究的主要目的是开发并对一种创新的、基于接受的行为减肥疗法进行初步评估，该疗法旨在促进长期坚持健康的饮食和体育活动行为，从而改善减肥的维持。

DESCRIPTION (provided by applicant): The United States is in the midst of an obesity epidemic and innovative approaches to address this problem are urgently needed. Although traditional behavioral treatment is the most empirically validated approach for weight loss, it typically results in poor maintenance of weight control behaviors, and within three to five years most participants in these programs will have regained the weight they originally lost. Standard behavioral weight loss treatment might be improved by incorporating components that (a) bolster participants' commitment to behavior change, (b) build distress tolerance skills and (c) promote mindful awareness of eating behaviors and goals. Such components are well- represented within newer models of behavior therapies that incorporate principles and technologies of mindfulness, experiential awareness, values for changing behavior, acceptance of distressing internal experiences, and willingness to tolerate distress in the service of valued behavior change. The primary goal of the proposed project is to determine if an innovative behavioral weight loss program that incorporates new developments from the field of behavior therapy produces superior weight control than standard behavioral treatment. A sample of 128 adults with a BMI of 27 to 40 kg/m2 will be recruited via media advertisements in the greater Philadelphia community to participate in this study. Participants will be randomly assigned to one of two conditions: standard behavioral treatment (SBT) or acceptance-based behavioral treatment (ABBT). Each treatment will be delivered in a group format on a weekly, and then bi-weekly, basis. Treatment will last 40 weeks: weeks 1-20 focus on weight loss, while weeks 21-40 partially shift focus to weight loss maintenance. Assessments will be completed at baseline, 10 weeks, 20 weeks (i.e., end of weight loss treatment), 40 weeks (i.e., end of weight loss maintenance treatment), and at 6-month follow-up. PUBLIC HEALTH RELEVANCE: Obesity is reaching epidemic proportions. Standard behavioral treatment for obesity effectively induces weight loss, but long-term maintenance of weight loss remains challenging. The primary aim of the proposed study is to develop and conduct a preliminary evaluation of an innovative, acceptance-based behavioral weight loss treatment that is designed to promote long-term adherence to healthy eating and physical activity behaviors and thereby improve weight loss maintenance.