Long‐Term Follow‐up of the Mind Your Health Project: Acceptance‐Based versus Standard Behavioral Treatment for Obesity

Abstract

Objective In the Mind Your Health Trial, acceptance‐based behavioral treatment (ABT) for obesity outperformed standard behavioral treatment (SBT) at posttreatment. This trial compared effects over 2 years of follow‐up. Methods Participants with overweight or obesity (n = 190) were randomized to 25 sessions of SBT or ABT over 1 year and assessed at months 12 (i.e., posttreatment), 24 (1 year posttreatment), and 36 (2 years posttreatment). Results Weight‐loss differences previously observed at 12 months attenuated by follow‐up, though a large difference was observed in the proportion of treatment completers who maintained 10% weight loss at 36 months (SBT = 17.1% vs. ABT = 31.6%; P = 0.04; intent‐to‐treat: SBT = 14.4% vs. ABT = 25.0%; P = 0.07). The amount of regain between posttreatment and follow‐up did not differ between groups. ABT produced higher quality of life at 24 and 36 months. Autonomous motivation and psychological acceptance of food‐related urges mediated the effect of condition on weight. No moderator effects were identified. Conclusions Overall, results suggest that infusing SBT for weight loss with acceptance‐based strategies enhances weight loss initially, but these effects fade in the years following the withdrawal of treatment. Even so, those receiving ABT were about twice as likely to maintain 10% weight loss at 36 months, and they reported considerably higher quality of life.

The Impact of Psychological Flexibility on Psychological Well-Being in Adults With Obesity

“…This could be a valid promising result supporting the application of ACTbased intervention for individuals with obesity. Further studies are required to address the validity of such interventions, but some evidence has been already collected (Forman et al, 2013(Forman et al, , 2016(Forman et al, , 2019Cattivelli et al, 2018).…”

Relationship between Dispositional Mindfulness, Psychological Health, and Diet Quality among Healthy Midlife Adults

“…Moreover, mindfulness-based interventions have been shown to reduce weight-related eating psychopathology, such as binge eating [35,41], as well as to reduce high calorie food intake following exposure to appetitive cues [42]. Indeed, there are now several mindfulness-based interventions for the treatment of disordered eating, including Acceptance and Commitment Therapy for Binge Eating Disorder and obesity [43][44][45], and Mindfulness-Based Eating Awareness Training (MB-EAT) [46][47][48]. Given the benefits of mindfulness practices for eating psychopathology, it is possible that these practices may be effective for improving other aspects of eating behavior, including dietary quality.…”

Acceptance-based therapy: the potential to augment behavioral interventions in the treatment of type 2 diabetes

“…Similarly, the Mind Your Health II Project (MYH II), a larger and longer (1 year) RCT, demonstrated that ABT produced greater 12-month weight loss than did the SBT treatment (13.3 vs. 9.8%), again when conducted by experienced clinicians 39 . In the long-term post-treatment follow-up data from MYH II 40 , weight loss at 24-months (7.5 vs. 5.6%; P = 0.15) or at 36 months (4.7 vs. 3.3%; P = 0.31) did not significantly differ between ABT and SBT groups. However, among treatment completers who attained at least 10% body weight loss during the intervention, those receiving ABT were almost twice as likely to retain at least 10% body weight loss at two-year followup (31.6 vs. 17.1%; P = 0.04).…”

“…Two randomized controlled trials (RCTs) have demonstrated significantly greater weight losses for ABT compared to SBT 39,40 . The Mind Your Health Project, a 40-week RCT comparing ABT to SBT, demonstrated that ABT resulted in significantly higher weight loss than SBT at post-treatment (13.2 vs. 7.5%) and at 6-month followup (11.0 vs. 5.0%) in a post-hoc analysis when the intervention was administered by weight-control experts 41 .…”