1
|
Di Sante J, Frayn M, Angelescu A, Knäuper B. Proof-of-concept testing of a brief virtual ACT workshop for emotional eating. Appetite 2024; 199:107386. [PMID: 38692511 DOI: 10.1016/j.appet.2024.107386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/08/2024] [Accepted: 04/28/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Emotional eating, or eating in response to negative emotions, is a commonly reported short-term emotion regulation strategy but has been shown to be ineffective in the long term. Most emotional eating interventions based on Acceptance and Commitment Therapy (ACT) have been delivered in the context of weight loss trials, highlighting a need for ACT-based emotional eating interventions in weight-neutral contexts. AIMS This proof-of-concept study aimed to test the acceptability and efficacy potential of a brief virtual ACT workshop for emotional eating in a small sample of adults identifying as emotional eaters. METHODS Twenty-six adult emotional eaters completed an ACT workshop delivered in two 1.5-h sessions over two weeks. The workshop targeted awareness and acceptance of emotions and eating urges, and valued actions around eating. RESULTS The acceptability of the workshop was demonstrated by high participant satisfaction. Significant improvements on all outcome measures were found and maintained up to 3 months follow-up. CONCLUSIONS These proof-of-concept findings suggest that a brief virtual ACT workshop may improve emotional eating and associated ACT processes. Results from this study can inform a future randomized controlled trial to test the efficacy of the workshop and the role of theoretical processes of change. TRIAL REGISTRATION ClinicalTrials.gov, NCT04457804. LEVEL OF EVIDENCE Level IV, evidence obtained from multiple time series with the intervention.
Collapse
Affiliation(s)
| | - Mallory Frayn
- Department of Psychology, McGill University, Quebec, Canada
| | | | - Bärbel Knäuper
- Department of Psychology, McGill University, Quebec, Canada
| |
Collapse
|
2
|
Hormes JM, Timko CA. A clinical trial protocol of a single-session self-guided acceptance-based online intervention targeting food cravings as predictors of disordered eating in pregnant people. Contemp Clin Trials 2024; 140:107515. [PMID: 38537903 DOI: 10.1016/j.cct.2024.107515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/18/2024] [Accepted: 03/24/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Pregnancy is a time of heightened risk for disordered eating behaviors, which are linked to adverse health outcomes in gestation, delivery, and the postpartum. These adverse outcomes may be partially mediated by greater rates of deviation from recommended weight gain trajectories, especially in those who engage in binge and loss of control (LOC) eating. Food cravings are powerful and highly modifiable triggers of binge and LOC eating in non-pregnant populations with preliminary evidence linking cravings to disordered eating behaviors in pregnancy as well. Acceptance-based approaches have been shown to be feasible and effective in reducing the adverse impact of cravings on behavior. PURPOSE To test the feasibility, acceptability, and preliminary efficacy of a single-session, self-guided, acceptance-based online workshop targeting food cravings as predictors of binge and LOC eating in pregnancy. METHODS We will conduct a pilot randomized controlled trial of a single-session, self-guided online acceptance-based workshop targeting food cravings in pregnancy. Pregnant individuals in the second trimester (n ≥ 74) endorsing current food cravings will be randomly assigned to the intervention or an untreated control group. The intervention group will participate in a one-hour workshop that imparts skills grounded in Acceptance and Commitment Therapy, including acceptance, defusion, and present-moment awareness. Both groups will complete comprehensive self-report assessments of primary outcomes and hypothesized mediators and moderators of intervention efficacy at baseline, one-month follow-up, and at full-term. CONCLUSION Results will inform integration of acceptance-based skills targeting food cravings into routine prenatal care to prevent adverse outcomes associated with disordered eating behaviors in pregnancy. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT06129461; registered on November 10, 2023.
Collapse
Affiliation(s)
- Julia M Hormes
- Department of Psychology, University at Albany, State University of New York, Social Sciences 399, 1400 Washington Ave, Albany, NY 12222, USA.
| | - C Alix Timko
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
| |
Collapse
|
3
|
Volpe VV, Collins AN, Ross JM, Ellis KR, Lewis JA, Ladd BA, Fitzpatrick SL. Black Young Adult Superwomen in the Face of Gendered Racial Microaggressions: Contextualizing Challenges With Acceptance and Avoidance and Emotional Eating. Ann Behav Med 2024; 58:305-313. [PMID: 38546737 DOI: 10.1093/abm/kaae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Black young adult women (ages 18-35) are at disproportionate risk for obesity and emotional eating. Emotional eating interventions target psychological flexibility, such as reducing experiential avoidance and increasing acceptance of food-related thoughts. Yet Black women face gendered racism, and some endorse roles that reduce psychological flexibility, such as the superwoman schema role. Culturally centered stress and coping has often been overlooked, leading to an incomplete understanding of processes that engender emotional eating and the implications for appropriate and effective interventions for Black young adult women. PURPOSE We investigated direct and indirect pathways of associations between stress from gendered racial microaggressions to emotional eating through the endorsement of superwoman schema and two aspects of psychological flexibility. METHODS Black young adult women (N = 504; Mage = 24.72; 75.2% African American; 98.4% cisgender) participated in an online survey wherein they reported demographics, stress from gendered racial microaggressions, superwoman schema, experiential avoidance, acceptance of food-related thoughts, and emotional eating. Path analysis was conducted to examine direct and indirect effects. RESULTS Results provided evidence for indirect associations between more stress from gendered racial microaggressions and more emotional eating. More stress was associated with greater endorsement of the superwoman schema which was associated with more experiential avoidance and less acceptance of food-related thoughts, which were each associated with more emotional eating. CONCLUSIONS Endorsement of superwoman schema and concomitant avoidance and less acceptance may be one way that gendered racial stress propels emotional eating. Future research could test intervention components that disrupt this path.
Collapse
Affiliation(s)
- Vanessa V Volpe
- Department of Psychology, North Carolina State University, Raleigh, NC, USA
| | - Abbey N Collins
- Department of Psychology, North Carolina State University, Raleigh, NC, USA
| | - Julia M Ross
- Department of Psychology, North Carolina State University, Raleigh, NC, USA
| | - Katrina R Ellis
- Schools of Social Work and Public Health, Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Jioni A Lewis
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, College Park, MD, USA
| | - Brianna A Ladd
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, College Park, MD, USA
| | - Stephanie L Fitzpatrick
- Feinstein Institutes for Medical Research at Northwell Health, Manhasset, NY, USA
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, Uniondale, NY, USA
| |
Collapse
|
4
|
Phelan S, Cardel MI, Lee AM, Alarcon N, Foster GD. Behavioral, psychological, and environmental predictors of weight regain in a group of successful weight losers in a widely available weight-management program. Obesity (Silver Spring) 2023; 31:2709-2719. [PMID: 37840409 DOI: 10.1002/oby.23903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The aim of this study was to identify predictors of weight regain and continued weight maintenance among individuals already successful at long-term weight loss in a widely available weight-management program. METHODS Participants were 2843 weight-loss maintainers in WeightWatchers who had maintained weight loss ≥9.1 kg for ≥1 year (average 25.5 kg for 3.5 years; BMI = 26.7 kg/m2 ). Validated behavioral, psychosocial, and home environmental questionnaires were administered at study entry and 1 year later. Discriminant analysis identified variables that discriminated gainers (≥2.3-kg gain) from maintainers (±2.3-kg change). RESULTS Over the 1 year of follow-up, 43% were gainers (mean [SD], 7.2 [5.4] kg), and 57% were maintainers (0.4 [1.2] kg). Compared with maintainers, gainers were younger and had higher initial weight, more recent weight losses, and larger initial weight losses. Standardized canonical coefficients indicated that the 1-year changes that most discriminated gainers from maintainers were greater decreases in the ability to accept uncomfortable food cravings, urges, and desires to overeat (0.232); self-monitoring (0.166); body image (0.363); and body satisfaction (0.194) and greater increases in disinhibition (0.309) and bodily pain (0.147). The canonical correlation was 0.505 (p < 0.001). CONCLUSIONS Future interventions to prevent regain should consider targeting overeating in response to internal and external food cues and declines in self-monitoring and body image.
Collapse
Affiliation(s)
- Suzanne Phelan
- Department of Kinesiology & Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, California, USA
| | - Michelle I Cardel
- WW International, Inc., New York, New York, USA
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | | | - Noemi Alarcon
- Department of Kinesiology & Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, California, USA
| | - Gary D Foster
- WW International, Inc., New York, New York, USA
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
5
|
Radin RM, Epel ES, Mason AE, Vaccaro J, Fromer E, Guan J, Prather AA. Impact of digital meditation on work stress and health outcomes among adults with overweight: A randomized controlled trial. PLoS One 2023; 18:e0280808. [PMID: 36857330 PMCID: PMC9977041 DOI: 10.1371/journal.pone.0280808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 12/16/2022] [Indexed: 03/02/2023] Open
Abstract
Mindfulness meditation may improve well-being at work; however, effects on food cravings and metabolic health are not well known. We tested effects of digital meditation, alone or in combination with a healthy eating program, on perceived stress, cravings, and adiposity. We randomized 161 participants with overweight and moderate stress to digital meditation ('MED,' n = 38), digital meditation + healthy eating ('MED+HE,' n = 40), active control ('HE,' n = 41), or waitlist control ('WL,' n = 42) for 8 weeks. Participants (n = 145; M(SD) BMI: 30.8 (5.4) kg/m2) completed baseline and 8-week measures of stress (Perceived Stress Scale), cravings (Food Acceptance and Awareness Questionnaire) and adiposity (sagittal diameter and BMI). ANCOVAs revealed that those randomized to MED or MED+HE (vs. HE or WL) showed decreases in perceived stress (F = 15.19, p < .001, η2 = .10) and sagittal diameter (F = 4.59, p = .03, η2 = .04), with no differences in cravings or BMI. Those high in binge eating who received MED or MED+HE showed decreases in sagittal diameter (p = .03). Those with greater adherence to MED or MED+HE had greater reductions in stress, cravings, and adiposity (ps < .05). A brief digital mindfulness-based program is a low-cost method for reducing perceptions of stress and improving abdominal fat distribution patterns among adults with overweight and moderate stress. Future work should seek to clarify mechanisms by which such interventions contribute to improvements in health. Trial registration: Clinical trial registration http://www.ClinicalTrials.gov: identifier NCT03945214.
Collapse
Affiliation(s)
- Rachel M. Radin
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Elissa S. Epel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Ashley E. Mason
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - Julie Vaccaro
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Elena Fromer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Joanna Guan
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Aric A. Prather
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| |
Collapse
|
6
|
Bricker JB, Mull KE, Sullivan BM, Forman EM, Lillis J, McTiernan A, Santiago-Torres M. Telehealth acceptance and commitment therapy for weight loss: Protocol of the WeLNES full scale randomized controlled trial. Contemp Clin Trials 2023; 126:107091. [PMID: 36682490 PMCID: PMC9998365 DOI: 10.1016/j.cct.2023.107091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/05/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
Behavioral interventions delivered via one-on-one telephone coaching (hereafter referred to as telehealth) for weight loss have had great population-level reach but to date limited efficacy. Acceptance and Commitment Therapy (ACT) has promise to improve behavioral weight loss treatment efficacy by addressing the fundamental challenges of weight loss and maintenance: overeating in response to internal (e.g., stress) and external (e.g., high calorie foods) cues. Here we describe the Weight Loss, Nutrition, and Exercise Study (WeLNES) randomized controlled trial that is testing the efficacy of an ACT-based telehealth coaching intervention for weight loss in comparison to a Standard Behavioral Therapy (SBT)-based telehealth coaching intervention. A total of 398 adults with overweight or obesity are being recruited and randomized to either ACT or SBT telehealth coaching. Participants in both arms are offered twenty-five telehealth coaching sessions in year one and nine booster sessions in year two. All participants receive a Bluetooth-enabled scale to self-monitor weight and a Fitbit Inspire + Fitbit app for tracking diet and physical activity. The primary aim is to determine whether a greater proportion of ACT participants will achieve a clinically significant weight loss of ≥10% compared with SBT participants at 12-months. Secondary outcomes include change in weight from baseline to 6, 12, and 24-months. Whether the effect of ACT on weight loss is mediated by ACT processes and is moderated by baseline factors will also be examined. If ACT proves efficacious, ACT telehealth coaching will offer an effective, broadly scalable weight loss treatment-thereby making a high public health impact.
Collapse
Affiliation(s)
- Jonathan B Bricker
- Fred Hutchinson Cancer Center, Division of Public Health Sciences, Seattle, WA, USA; University of Washington, Department of Psychology, Seattle, WA, USA
| | - Kristin E Mull
- Fred Hutchinson Cancer Center, Division of Public Health Sciences, Seattle, WA, USA
| | - Brianna M Sullivan
- Fred Hutchinson Cancer Center, Division of Public Health Sciences, Seattle, WA, USA
| | - Evan M Forman
- Center for Weight, Eating and Lifestyle Science, Drexel University, Philadelphia, PA, USA
| | - Jason Lillis
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA; College of Psychology, California Northstate University, Elk Grove, CA, USA
| | - Anne McTiernan
- Fred Hutchinson Cancer Center, Division of Public Health Sciences, Seattle, WA, USA; University of Washington School of Public Health, Department of Epidemiology, USA; University of Washington School of Medicine, Department of Medicine, USA
| | | |
Collapse
|
7
|
Barley EA, Bovell M, Bennett-Eastley K, Lee JT, Lee-Baggley D, Skene SS, Tai MZ, Brooks S, Scholtz S. Addressing a critical need: A randomised controlled feasibility trial of acceptance and commitment therapy for bariatric surgery patients at 15-18 months post-surgery. PLoS One 2023; 18:e0282849. [PMID: 37098049 PMCID: PMC10128967 DOI: 10.1371/journal.pone.0282849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 02/17/2023] [Indexed: 04/26/2023] Open
Abstract
Bariatric surgery is an effective treatment for obesity. However, around one in five people experience significant weight regain. Acceptance and Commitment Therapy (ACT) teaches acceptance of and defusion from thoughts and feelings which influence behaviour, and commitment to act in line with personal values. To test the feasibility and acceptability of ACT following bariatric surgery a randomised controlled trial of 10 sessions of group ACT or Usual Care Support Group control (SGC) was delivered 15-18 months post bariatric surgery (ISRCTN registry ID: ISRCTN52074801). Participants were compared at baseline, 3, 6 and 12 months using validated questionnaires to assess weight, wellbeing, and healthcare use. A nested, semi-structured interview study was conducted to understand acceptability of the trial and group processes. 80 participants were consented and randomised. Attendance was low for both groups. Only 9 (29%) ACT participants completed > = half of the sessions, this was the case for 13 (35%) SGC participants. Forty-six (57.5%) did not attend the first session. At 12 months, outcome data were available from 19 of the 38 receiving SGC, and from 13 of the 42 receiving ACT. Full datasets were collected for those who remained in the trial. Nine participants from each arm were interviewed. The main barriers to group attendance were travel difficulties and scheduling. Poor initial attendance led to reduced motivation to return. Participants reported a motivation to help others as a reason to join the trial; lack of attendance by peers removed this opportunity and led to further drop out. Participants who attended the ACT groups reported a range of benefits including behaviour change. We conclude that the trial processes were feasible, but that the ACT intervention was not acceptable as delivered. Our data suggest changes to recruitment and intervention delivery that would address this.
Collapse
Affiliation(s)
- Elizabeth A Barley
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Marie Bovell
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Kate Bennett-Eastley
- School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - John Tayu Lee
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | | | - Simon S Skene
- School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - Michael Z Tai
- Department of Psychiatry, St Charles Hospital, London, United Kingdom
| | - Sue Brooks
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Samantha Scholtz
- Division of Diabetes, Endocrinology and Metabolism, Imperial College, London, United Kingdom
| |
Collapse
|
8
|
Hayes SC, Ciarrochi J, Hofmann SG, Chin F, Sahdra B. Evolving an idionomic approach to processes of change: Towards a unified personalized science of human improvement. Behav Res Ther 2022; 156:104155. [DOI: 10.1016/j.brat.2022.104155] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/08/2022] [Accepted: 06/28/2022] [Indexed: 12/11/2022]
|
9
|
Peláez-Fernández MA, Sepúlveda AR, Compte EJ. Editorial: Eating Disorders and Weight Disorders: Assessment, Early Diagnosis, Prognosis, Treatment Outcome and the Role of Potential Psychological and Social Factors. Front Psychol 2022; 13:924815. [PMID: 35719510 PMCID: PMC9198596 DOI: 10.3389/fpsyg.2022.924815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/19/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- María Angeles Peláez-Fernández
- Department of Social Psychology, Social Work and Social Services, and Social Anthropology, Faculty of Psychology and Logopedics, University of Málaga, Málaga, Spain
| | - Ana R Sepúlveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Emilio J Compte
- Eating Behavior Research Center, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile.,Research Department, Comenzar de Nuevo Treatment Center, Monterrey, Mexico
| |
Collapse
|
10
|
Ahern AL, Richards R, Jones RA, Whittle F, Mueller J, Woolston J, Sharp SJ, Hughes CA, Hill AJ, Duschinsky R, Lawlor ER, Morris S, Fusco F, Brennan A, Bostock J, Griffin SJ. Acceptability and feasibility of an acceptance and commitment therapy-based guided self-help intervention for weight loss maintenance in adults who have previously completed a behavioural weight loss programme: the SWiM feasibility study protocol. BMJ Open 2022; 12:e058103. [PMID: 35440459 PMCID: PMC9020279 DOI: 10.1136/bmjopen-2021-058103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The cost-effectiveness and long-term health impact of behavioural weight management programmes depends on post-treatment weight-loss maintenance. Growing evidence suggests that interventions using acceptance and commitment therapy (ACT) could improve long-term weight management. We developed an ACT-based, guided self-help intervention to support adults who have recently completed a behavioural weight loss programme. This study will assess the feasibility and acceptability of this type of intervention and findings will inform the development of a full-scale trial. METHODS AND ANALYSIS This is a pragmatic, randomised, single-blind, parallel group, two-arm, feasibility study with an embedded process evaluation. We will recruit and randomise 60 adults who have recently completed a behavioural weight loss programme to the ACT-based intervention or standard care, using a computer-generated sequence with 2:1 allocation stratified by diabetes status and sex. Baseline and 6-month measurements will be completed using online questionnaires. Qualitative interviews will be conducted with a subsample of participants and coaches about their experiences at 3 (mid-intervention) and 6 (postintervention) months. Feasibility and acceptability of the intervention, and a full-scale trial will be assessed using a number of outcomes, including adherence to, and engagement with the intervention, recruitment and retention rates, proportion of missing data for each outcome measure, participants' experiences of the intervention and study, and coaches' experiences of delivering intervention support. Quantitative and qualitative findings will be integrated and summarised to contribute to the interpretation of the main feasibility evaluation findings. Value of information methods will be used to estimate the decision uncertainty associated with the intervention's cost-effectiveness and determine the value of a definitive trial. ETHICS AND DISSEMINATION Ethical approval was received from Cambridge South Research Ethics Committee on 15/03/2021 (21/EE/0024). This protocol (V.2) was approved on 19 April 2021. Findings will be published in peer-reviewed scientific journals and communicated to other stakeholders as appropriate. TRIAL REGISTRATION NUMBER ISRCTN12685964.
Collapse
Affiliation(s)
- Amy L Ahern
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Rebecca Richards
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Rebecca A Jones
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Fiona Whittle
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Julia Mueller
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Jenny Woolston
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Carly A Hughes
- Fakenham Medical Practice, Fakenham, UK
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | | | - Robbie Duschinsky
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Emma Ruth Lawlor
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Stephen Morris
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Francesco Fusco
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Alan Brennan
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Jennifer Bostock
- Quality and Outcomes of Person-Centred Care Policy Research Unit, Canterbury, UK
| | - Simon J Griffin
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| |
Collapse
|
11
|
Hu J, Liu M, Yang R, Wang L, Liang L, Yang Y, Jia S, Chen R, Liu Q, Ren Y, Zhu L, Cai M. Effects of high-intensity interval training on improving arterial stiffness in Chinese female university students with normal weight obese: a pilot randomized controlled trial. J Transl Med 2022; 20:60. [PMID: 35109880 PMCID: PMC8809004 DOI: 10.1186/s12967-022-03250-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/14/2022] [Indexed: 12/24/2022] Open
Abstract
Background High intensity interval training (HIIT) has been reported to exert better effects on cardiovascular fitness in obesity, but little known about the arterial stiffness (AS) in female university students with normal weight obesity (NWO). Thus, this study aimed to investigate the effects of HIIT on the body composition, heart rate (HR), blood pressure (BP), blood lipids metabolism as well as the novel parameters of propensity for AS (arterial velocity pulse index [AVI], arterial pressure volume index [API]) for female university students with NWO. Methods Forty female university students with NWO were randomly assigned to control group (n = 20) and HIIT group (3 bouts of 9‑min intervals at 90% of the maximal heart rate [HRmax], interspersed by 1 min rest, 5 days a week, n = 20). Tests were performed before and after 4 weeks of training. Repeated measures ANOVA and simple effect test analysis were used to analyze dependent variable changes. Results After 4 weeks HIIT statistically significantly improved the body composition by decreasing the body mass index, body fat percent, total body fat mass (BFM), BFM of left arm, measured circumference of left arm, and obesity degree, and increasing the total body skeletal muscle mass, protein content, total body water, fat free mass, body cell mas, and InBody score. HIIT also statistically significantly decreased the HR and BP. As for the lipid profile, HIIT obviously ameliorated the blood lipids metabolism by decreasing the levels of total cholesterol (TC), triglyceride, low-density lipoprotein, and TC/HDL, and increasing the levels of high-density lipoprotein (HDL). In addition, the AVI and API were markedly decreased via HIIT intervention. Conclusions HIIT produced significant and meaningful benefits for body composition, HR, BP, and blood lipids metabolism, and could decrease AS in female university students with NWO. This suggests that HIIT may effectively reduce the risk of arteriosclerosis and protect the cardiovascular function for female university students with NWO. Trial registration ChiCTR2100050711. Registered 3 September 2021. Retrospectively registered.
Collapse
|
12
|
Di Sante J, Akeson B, Gossack A, Knäuper B. Efficacy of ACT-Based treatments for dysregulated eating behaviours: A systematic review and meta-analysis. Appetite 2022; 171:105929. [PMID: 35032613 DOI: 10.1016/j.appet.2022.105929] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND An increasing number of studies have investigated the efficacy of Acceptance and Commitment Therapy (ACT) for the reduction of dysregulated eating behaviours such as binge eating and emotional eating. However, little is known about their short- and long-term efficacy and underlying mechanisms of change. OBJECTIVES To conduct a systematic effect size analysis to estimate the efficacy of ACT-based treatments on measures of dysregulated eating and of psychological flexibility, a theorized ACT mechanism of change. METHODS Literature searches were conducted in PsycInfo, Medline, Web of Science, and ProQuest Dissertations. Within-group and between-group standardized mean differences were computed using Comprehensive Meta-Analysis Version 3. Additional subgroup and meta-regression analyses by study characteristics were conducted. RESULTS A total of 20 publications (22 samples, n = 1269) were included. Pre-post and pre-follow-up effects suggest that ACT-based treatments are moderately effective in reducing dysregulated eating behaviours and increasing psychological flexibility. These effects were comparable for binge-eating and emotional eating outcomes and for face-to-face interventions, Web-based interventions, and interventions that used a self-help book. Longer treatments were associated with larger outcome effect sizes, and changes in psychological flexibility were not associated with changes in dysregulated eating outcomes. Small significant effects were found in favour of ACT when compared to inactive control groups. The only three studies that included active control groups and did not show significant differences in outcomes between ACT and other treatments. CONCLUSION Future studies should aim to compare ACT-based treatments to active treatments and to provide empirical evidence for the theoretical mediating role of psychological flexibility in reported changes in eating behaviour.
Collapse
Affiliation(s)
| | - Bianca Akeson
- Department of Psychology, McGill University, Quebec, Canada
| | - Amanda Gossack
- Department of Psychology, McGill University, Quebec, Canada
| | - Bärbel Knäuper
- Department of Psychology, McGill University, Quebec, Canada
| |
Collapse
|
13
|
Burton Murray H, Zhang F, Manasse SM, Forman EM, Butryn ML, Juarascio AS. Validation of the food craving Acceptance and action questionnaire (FAAQ) in a weight loss-seeking sample. Appetite 2022; 168:105680. [PMID: 34487734 PMCID: PMC8671291 DOI: 10.1016/j.appet.2021.105680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The Food Craving Acceptance and Action Questionnaire (FAAQ) was developed to measure psychological flexibility around food-related internal experiences (e.g., thoughts, feelings, urges) and has two subscales, acceptance and willingness. However, the FAAQ factor structure has not yet been systematically validated with a clinically relevant sample. METHODS Two weight-loss treatment seeking samples (total N = 462; 80.4% female) ages 18 to 70 (M = 52.6, SD = 9.8) completed the FAAQ before and after group-based treatment of overweight or obesity. RESULTS Confirmatory factor analysis on the FAAQ's previously observed two-factor model produced poor model fit. An alternative 7-item model removing specific items that contributed to poor fit and were conceptually relevant to remove provided good model fit. The resulting revised 7-item FAAQ (items 1,3,6 removed) had adequate internal consistency and significant predictive validity for the Total score and subscales, and showed initial construct validity for the Total score. CONCLUSIONS Results from this study suggest researchers and clinicians should now use the 7-item FAAQ-II, which retains the Willingness and Acceptance subscales. Future research is needed with other relevant samples to confirm the FAAQ-II's factor structure and psychometric properties.
Collapse
Affiliation(s)
- Helen Burton Murray
- Department of Psychology, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA; Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA; Center for Neurointestinal Health, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
| | - Fengqing Zhang
- Department of Psychology, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA; Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA
| | - Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA
| | - Evan M Forman
- Department of Psychology, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA; Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA
| | - Meghan L Butryn
- Department of Psychology, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA; Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA
| | - Adrienne S Juarascio
- Department of Psychology, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA; Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton 226, Philadelphia, PA, 19104, USA
| |
Collapse
|
14
|
Real-time fluctuations in mindful awareness, willingness, and values clarity, and their associations with craving and dietary lapse among those seeking weight loss. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021; 22:87-92. [PMID: 34900572 DOI: 10.1016/j.jcbs.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Mindful awareness, willingness and values clarity have been examined as protective factors across a wide range of problems, including overweight/obesity. However, these variables have almost exclusively been examined at the trait-level. It is possible that these variables also fluctuate within individuals in daily life, and that these intraindividual fluctuations may in turn be related to food craving and dietary lapse. The current study used ecological momentary assessment (EMA) to examine the extent to which momentary mindful awareness, willingness, and values clarity varied within-person, and were associated with craving and likelihood of dietary lapse among weight-loss seeking individuals with overweight/obesity prior to starting a weight loss program. We also examined the extent to which craving was associated with dietary lapse. Methods Adults with overweight/obesity (N = 126) completed one week of EMA prior to enrolling in a randomized controlled trial of behavioral weight loss treatments. They responded to EMA questions assessing dietary lapses, craving, mindful awareness, willingness, and values clarity six-times per day. Results Mindful awareness, willingness, and values clarity demonstrated substantial within-person variability, and higher within-person mindful awareness, willingness, and values clarity were concurrently (but not prospectively) associated with lower craving and likelihood of dietary lapse. Higher craving was concurrently (but not prospectively) associated with higher likelihood of dietary lapse. Between-person, higher mindful awareness, willingness, and values clarity were associated with lower craving and likelihood of dietary lapse, and higher craving was associated with greater frequency of dietary lapses. Conclusion Mindful awareness, willingness, and values clarity vary substantially at the daily level, and may be important mechanisms to target to reduce craving and dietary lapses in the daily lives of individuals with overweight/obesity.
Collapse
|
15
|
Schaefer LM, Crosby RD, Machado PP. A systematic review of instruments for the assessment of eating disorders among adults. Curr Opin Psychiatry 2021; 34:543-562. [PMID: 34475351 PMCID: PMC8645259 DOI: 10.1097/yco.0000000000000746] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW The availability of psychometrically sound assessment instruments for assessing eating disorder symptomatology is crucial for both clinical practice and research. The purpose of the current review is to provide the reader with a list of psychometrically validated assessments for adults that are available within the field of eating disorders. Eating disorder interviews and self-report questionnaires were identified using online literature searches, reviewing previous review articles, and via research and/or clinical experience of the authors. The focus of the review was on (1) standard assessments that were frequently used in eating disorder research (such as the Eating Disorder Examination and Eating Attitudes Test), and (2) newer assessments that were developed over the past 5 years. Information compiled on each instrument included the purpose of the assessment, scores that can be derived, psychometric information, translations in other languages, and availability for use in research and clinical settings. RECENT FINDINGS Several recent trends in assessment instruments were identified including updates based upon Diagnostic and Statistical Manual criteria, briefer assessments, assessments for specific populations, and assessment of specific clinical features observed in people with eating disorders. SUMMARY The current review provides eating disorder clinicians and researchers a guide for making informed decisions about the selection of eating disorder assessments.
Collapse
Affiliation(s)
- Lauren M. Schaefer
- Sanford Center for Bio-behavioral Research, Fargo, ND, USA
- University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Ross D. Crosby
- Sanford Center for Bio-behavioral Research, Fargo, ND, USA
- University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Paulo P.P. Machado
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| |
Collapse
|
16
|
Forman EM, Chwyl C, Berry MP, Taylor LC, Butryn ML, Coffman DL, Juarascio A, Manasse SM. Evaluating the efficacy of mindfulness and acceptance-based treatment components for weight loss: Protocol for a multiphase optimization strategy trial. Contemp Clin Trials 2021; 110:106573. [PMID: 34555516 DOI: 10.1016/j.cct.2021.106573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022]
Abstract
Behavioral weight loss treatment (BT) for individuals with overweight and obesity is effective but leaves room for improvement. Mindfulness and acceptance-based treatments may bolster weight loss outcomes; yet, little is known about the efficacy of the individual components or the combinations of components that are most effective in producing weight loss above and beyond standard BT strategies for weight loss. This protocol manuscript describes the use of a multiphase optimization strategy to evaluate the independent and combinatory efficacy of three mindfulness and acceptance-based components (mindful awareness, willingness, values). Using a 2 × 2 × 2 factorial design, participants (N = 288) will be randomized to one of eight conditions, each representing a combination of core MABT strategies in addition to foundational BT strategies. Assessments occur at baseline, mid-treatment (week 24 through 26), post-treatment, and at 6, 12, and 24-month follow-up. The primary aim is to elucidate the independent efficacy of each MABT component on weight loss above gold-standard BT. The secondary aims are to evaluate the independent effect of these components on calorie intake, physical activity, and overall quality of life; evaluate target engagement (i.e., the degree to which each treatment component affects proposed mechanisms of action); and evaluate the potential moderating effect of susceptibility to internal and external food cues on outcomes. The exploratory aim is to quantify any component interaction effects (which may be synergistic, fully additive, or partially additive).
Collapse
Affiliation(s)
- Evan M Forman
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA.
| | - Christina Chwyl
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Michael P Berry
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Lauren C Taylor
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Donna L Coffman
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Adrienne Juarascio
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA
| |
Collapse
|
17
|
Manchón J, Quiles M, López-Roig S. The Role of Acceptance in Eating Behaviors-Spanish Validation of Food Craving Acceptance and Action Questionnaire (FAAQ-S). Front Psychol 2021; 12:717886. [PMID: 34434153 PMCID: PMC8381361 DOI: 10.3389/fpsyg.2021.717886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
Background: The Food Craving Acceptance and Action Questionnaire (FAAQ) was developed to measure food craving acceptance, but has not yet been adapted to Spanish. The aim of this study was to validate the FAAQ to the Spanish population and to analyze its psychometric properties. Method: Two studies were conducted. In the first study, the sample consisted of 224 undergraduate students who participated in the comprehension of the Spanish version and the Confirmatory Factor Analysis (CFA). The second sample consisted of 378 participants from a community sample who completed the refined version of the FAAQ and similar and dissimilar measures. Results: Study (1) The CFA was conducted, showing an inadequate fit of the model (CFI = 0.74, RMSEA = 0.18). Therefore, FAAQ was refined and it was administered to the community sample. Study (2) After an exploratory factor analysis, two factors were obtained as in the original FAAQ, Acceptance (30.92% variance explained) and Willingness (36.05%). The internal consistency was adequate for both subscales (ω = 0.88 and ω = 0.87, respectively). Correlation between the factors was r = 0.07, which provides evidence that Acceptance and Willingness are different constructs. Correlations of Acceptance with similar variables (r between −0.30 and −0.52) were stronger than the dissimilar measures (r between −0.26 and 0.24). This did not occur for the Willingness subscale, since correlations were low in all cases (r between −0.22 and 0.25). Conclusions: Spanish version of the FAAQ showed evidence of its reliability and validity, and may be a measure to provide a better understanding of how acceptance of thoughts and emotions concerning food and willingness impact eating management behaviors.
Collapse
Affiliation(s)
| | - Maria Quiles
- Miguel Hernández University of Elche, Elche, Spain
| | | |
Collapse
|
18
|
Bricker JB, Mull KE, Sullivan BM, Forman EM. Efficacy of telehealth acceptance and commitment therapy for weight loss: a pilot randomized clinical trial. Transl Behav Med 2021; 11:1527-1536. [PMID: 33787926 DOI: 10.1093/tbm/ibab012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Telehealth coaching for weight loss has high population-level reach but limited efficacy. To potentially improve on this limitation, the purpose of this study was to determine the preliminary efficacy of the first known telephone coaching acceptance and commitment therapy (ACT) intervention for weight loss. A two-arm, stratified, individually randomized pilot trial comparing ACT (n = 53) with standard behavioral therapy (SBT; n = 52) was used for this study. Both interventions were delivered in 25 telephone coaching calls (15-20 min each) over a 12 month period. Weight was measured at baseline and 3, 6, and 12 month postrandomization follow-ups. Recruited from 32 U.S. states, participants were of mean age 40.7, 42% male, 34% racial/ethnic minority, and mean baseline body mass index of 34.3. Fractions of 10% or more scale-reported weight loss: 15% for ACT versus 4% for SBT at 3 month follow-up (N = 86; odds ratio [OR] = 4.61; 95% confidence interval [CI]: 0.79, 26.83), 24% for ACT versus 13% for SBT at 6 month follow-up (N = 72; OR = 2.45; 95% CI: 0.65, 9.23), 30% for ACT versus 30% for SBT at 12 month follow-up (N = 57; OR = 0.93; 95% CI: 0.28, 3.09). Fractions of 10% or more self-reported weight loss at 12 month follow-up: 25% for ACT versus 15% for SBT (N = 75; OR = 2.38; 95% CI: 0.68, 8.34). The conclusion of the study was the preliminary evidence that telephone coaching ACT may be efficacious for weight loss.
Collapse
Affiliation(s)
- Jonathan B Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.,Department of Psychology, University of Washington, Seattle, WA 98195, USA
| | - Kristin E Mull
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Brianna M Sullivan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Evan M Forman
- Department of Psychology, and Center for Weight, Eating and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA
| |
Collapse
|
19
|
Lillis J, Schumacher L, Thomas JG, Levin ME, Dunsiger S, Unick JL, Evans E, Hayes JF, Wing RR. Study protocol for a randomized controlled trial comparing two low-intensity weight loss maintenance interventions based on acceptance and commitment therapy or self-regulation. Contemp Clin Trials 2021; 103:106327. [PMID: 33631360 DOI: 10.1016/j.cct.2021.106327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Weight regain is common following behavioral obesity treatment and attenuates many of the benefits of initial weight loss. This paper describes a randomized controlled trial that will evaluate the efficacy of two low-contact weight loss maintenance interventions based on Acceptance and Commitment Therapy (ACT) and self-regulation (SR). Potential mechanisms of action and moderators of treatment effects will also be evaluated. METHODS Adults (anticipated N = 480) with overweight or obesity will complete an initial 3-month online weight loss program (Phase 1). Participants who achieve ≥4 kg weight loss (anticipated N = 288) will then be randomized to an ACT or SR weight loss maintenance intervention. Both interventions will entail four 2.5 h, face-to-face, group-based workshop sessions and 6 months of email contact. Assessments will be conducted at phase 1 baseline, phase 1 completion/pre-randomization, and 6, 12, 18, 24, and 30 months post-randomization. The primary outcome will be weight change for the period from randomization to 30 months. Potential process measures including ACT-based constructs (e.g., psychological acceptance, values-consistent behavior), self-weighing frequency, and motivation will be also be assessed, as will potential moderators (e.g., initial weight loss). CONCLUSIONS This study will compare the efficacy of two intervention approaches (ACT and SR) delivered in a scalable workshop format for long-term weight loss maintenance. Future research could examine efficacy and cost-effectiveness of these approaches in real world settings.
Collapse
Affiliation(s)
- Jason Lillis
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
| | - Leah Schumacher
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Michael E Levin
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Shira Dunsiger
- Department of Behavioral and Social Sciences, Brown University, School of Public Health, Providence, RI, USA
| | - Jessica L Unick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Erin Evans
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Jacqueline F Hayes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| |
Collapse
|
20
|
Frayn M, Khanyari S, Knäuper B. A 1-day acceptance and commitment therapy workshop leads to reductions in emotional eating in adults. Eat Weight Disord 2020; 25:1399-1411. [PMID: 31541426 DOI: 10.1007/s40519-019-00778-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/06/2019] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Emotional eating has been defined as the tendency to overeat in response to negative emotions and is a symptom of emotion dysregulation. Interventions for emotional eating have been developed based on acceptance and commitment therapy (ACT). However, these interventions only address emotional eating in the context of weight loss programs and are therefore not available in a weight neutral context. METHODS The present study aimed to test the feasibility and acceptability of a 1-day ACT workshop that taught skills to reduce emotional eating, without promoting weight loss. The workshop was delivered in a single day and aimed to reduce emotional eating by improving values clarification and commitment, acceptance, and mindfulness. Follow-ups were conducted at 2 weeks and 3 months post-intervention. RESULTS Results suggest feasibility and acceptability of the 1-day workshop; participants described appreciating the brevity of the program and its applicability to their everyday lives. Improvements in emotional eating were found at 2 weeks (t(31) = 5.80, p < 0.001) and 3 months (t(29) = 6.96, p < 0.001). A repeated measures MANOVA revealed a significant main effect of time (F(14, 96) = 4.98, p < 0.001, partial η2 = 0.421), with follow-up ANOVAs indicating that this effect held for all variables. CONCLUSION The results from this study can be used to inform a larger-scale randomized controlled trial to determine the efficacy of the program in a larger sample and eventually disseminate it in other real-world settings. TRIAL REGISTRATION ClinicalTrials.gov, NCT03744780. LEVEL OF EVIDENCE Level IV, evidence obtained from multiple time series with the intervention.
Collapse
Affiliation(s)
- Mallory Frayn
- Department of Psychology, McGill University, 2001 McGill College, Montreal, QC, H3A 1G1, Canada.
| | - Sabrah Khanyari
- Department of Psychology, McGill University, 2001 McGill College, Montreal, QC, H3A 1G1, Canada
| | - Bärbel Knäuper
- Department of Psychology, McGill University, 2001 McGill College, Montreal, QC, H3A 1G1, Canada
| |
Collapse
|
21
|
Phelan S, Halfman T, Pinto AM, Foster GD. Behavioral and Psychological Strategies of Long-Term Weight Loss Maintainers in a Widely Available Weight Management Program. Obesity (Silver Spring) 2020; 28:421-428. [PMID: 31970912 PMCID: PMC7003766 DOI: 10.1002/oby.22685] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 10/02/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The study's purpose was to use validated questionnaires to identify novel behavioral and psychological strategies among weight loss maintainers (WLMs) in a commercial weight management program. METHODS Participants were 4,786 WLMs in WW (formerly Weight Watchers, New York, New York) who had maintained weight loss ≥ 9.1 kg (24.7 kg/23.8% weight loss on average) for 3.3 years and had a current mean BMI of 27.6 kg/m2 . A control group of 528 weight-stable individuals with obesity had a mean BMI of 38.9 kg/m2 and weight change < 2.3 kg over the previous 5 years. RESULTS WLMs versus Controls practiced more frequent healthy dietary choices (3.3 vs. 1.9; η p 2 = 0.37), self-monitoring (2.6 vs. 0.7; η p 2 = 0.30), and psychological coping (2.5 vs. 1.1; η p 2 = 0.25) strategies. WLMs also reported more willingness to ignore food cravings (4.4 vs. 3.5; η p 2 = 0.16) and had greater habit strength for healthy eating (5.3 vs. 3.2; η p 2 = 0.21). Standard canonical coefficients indicated that dietary (0.52), self-monitoring (0.40), and psychological (0.14) strategies as well as habit strength for healthy eating (0.15) contributed independently and most (49.5% of variance) to discriminating groups. CONCLUSIONS In a widely available weight management program, more frequent practice of healthy dietary, self-monitoring, and psychological coping strategies as well as development of greater habit strength for healthy eating differentiated long-term WLMs from weight-stable individuals with obesity.
Collapse
Affiliation(s)
- Suzanne Phelan
- Department of Kinesiology and Public Health & Center for Health ResearchCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Tate Halfman
- Department of Kinesiology and Public Health & Center for Health ResearchCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Angela Marinilli Pinto
- WW International, Inc.New YorkNew YorkUSA
- Psychology DepartmentBaruch CollegeCity University of New YorkNew YorkNew YorkUSA
| | - Gary D. Foster
- WW International, Inc.New YorkNew YorkUSA
- Center for Weight and Eating DisordersPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| |
Collapse
|
22
|
Barney JL, Murray HB, Manasse SM, Dochat C, Juarascio AS. Mechanisms and moderators in mindfulness- and acceptance-based treatments for binge eating spectrum disorders: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2019; 27:352-380. [PMID: 30887695 PMCID: PMC6570825 DOI: 10.1002/erv.2673] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 02/21/2019] [Accepted: 02/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Increasing evidence suggests that mindfulness- and acceptance-based psychotherapies (MABTs) for bulimia nervosa (BN) and binge eating disorder (BED) may be efficacious; however, little is known about their active treatment components or for whom they may be most effective. METHODS We systematically identified clinical trials testing MABTs for BN or BED through PsychINFO and Google Scholar. Publications were categorized according to analyses of mechanisms of action and moderators of treatment outcome. RESULTS Thirty-nine publications met inclusion criteria. Twenty-seven included analyses of therapeutic mechanisms, and five examined moderators of treatment outcome. Changes were largely consistent with hypothesized mechanisms of MABTs, but substandard mediation analyses, inconsistent measurement tools, and infrequent use of mid-treatment assessment points limited our ability to make strong inferences. DISCUSSION Analyses of mechanisms of action and moderators of outcome in MABTs for BN and BED appear promising, but the use of more sophisticated statistical analyses and adequate replication is necessary.
Collapse
Affiliation(s)
| | - Helen B Murray
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
| | | | - Cara Dochat
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California
| | | |
Collapse
|
23
|
A review of AAQ variants and other context-specific measures of psychological flexibility. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.02.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
24
|
Carels RA, Caroline Miller J, Selensky JC, Hlavka R, Solar C, Rossi J, Ellis J. Using an acceptance-based behavioral approach as a supplement to obesity treatment: A stepped-care approach. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
25
|
Forman EM, Manasse SM, Butryn ML, Crosby RD, Dallal DH, Crochiere RJ. Long-Term Follow-up of the Mind Your Health Project: Acceptance-Based versus Standard Behavioral Treatment for Obesity. Obesity (Silver Spring) 2019; 27:565-571. [PMID: 30806492 DOI: 10.1002/oby.22412] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 12/17/2018] [Indexed: 12/28/2022]
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.
Collapse
Affiliation(s)
- Evan M Forman
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie M Manasse
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Meghan L Butryn
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ross D Crosby
- Sanford Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, Fargo, North Dakota, USA
| | - Diane H Dallal
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Rebecca J Crochiere
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
26
|
Salazar DM, Ruiz FJ, Suárez-Falcón JC, Barreto-Zambrano ML, Gómez-Barreto MP, Flórez CL. Psychometric properties of the Avoidance and Fusion Questionnaire – Youth in Colombia. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2018.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
27
|
Mason AE, Saslow L, Moran PJ, Kim S, Wali PK, Abousleiman H, Hartman A, Richler R, Schleicher S, Hartogensis W, Epel ES, Hecht F. Examining the Effects of Mindful Eating Training on Adherence to a Carbohydrate-Restricted Diet in Patients With Type 2 Diabetes (the DELISH Study): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e11002. [PMID: 30545813 PMCID: PMC6401674 DOI: 10.2196/11002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/30/2018] [Accepted: 09/19/2018] [Indexed: 01/03/2023] Open
Abstract
Background Diet patterns have a profound influence on glycemic control for individuals with type 2 diabetes mellitus (T2DM), and craving-related eating is an important obstacle to dietary adherence. A growing body of research suggests that carbohydrate-restricted (CR) diets can improve glycemic control and reduce medication dependence in T2DM. However, limited data speak to the effects of long-term adherence to CR diets. Mindful eating training has been shown to reduce craving-related eating in overweight populations but has yet to be examined as a behavioral support for dietary adherence in T2DM. This trial examines behavioral mechanisms, particularly craving-related eating, through which mindful eating training might improve adherence to CR dietary recommendations in T2DM. This will clarify the importance of focusing on craving-related eating in the optimization of dietary adherence interventions. Objective The aim of this trial is to determine whether providing training in mindful eating increases adherence to a CR dietary recommendation in T2DM. Methods We are randomizing 60 participants to receive a CR diet with or without mindful eating training (12-week group intervention) and are following participants for 12 weeks after intervention completion. We hypothesize that participants who receive mindful eating training (relative to those who do not) will demonstrate greater adherence to the CR diet. Results Our primary outcome is change in craving-related eating, as assessed using an ecological momentary assessment mobile phone–based platform. Secondary behavioral pathway outcomes include changes in stress-related eating, impulsivity, glycemic control, weight change, dietary adherence, and resumption of dietary adherence after dietary nonadherence. Conclusions This theory-driven trial will shed light on the impact of mindfulness training on mechanisms that may impact dietary adherence in T2DM. Trial Registration ClinicalTrials.gov NCT03207711; https://clinicaltrials.gov/ct2/show/NCT03207711 (Archived by WebCite at http://www.webcitation.org/73pXscwaU)
Collapse
Affiliation(s)
- Ashley E Mason
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States.,Center for Health and Community, Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Laura Saslow
- School of Nursing, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Patricia J Moran
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Sarah Kim
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, San Francisco General Hospital, San Francisco, CA, United States
| | - Priyanka K Wali
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Hiba Abousleiman
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Alison Hartman
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Robert Richler
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | | | - Wendy Hartogensis
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Elissa S Epel
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States.,Center for Health and Community, Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Frederick Hecht
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| |
Collapse
|
28
|
Schumacher LM, Godfrey KM, Forman EM, Butryn ML. Change in Domain-specific but not General Psychological Flexibility Relates to Greater Weight Loss in Acceptance-Based Behavioral Treatment for Obesity. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019; 12:59-65. [PMID: 33101889 DOI: 10.1016/j.jcbs.2019.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Acceptance-based approaches have demonstrated promise for improving outcomes in behavioral treatments for obesity, but few studies have examined processes of change in these treatments. It is critical to identify mechanisms of action in treatment to further optimize this approach, refine theory, and inform future research. This study examined change in several domain-specific and general measures of psychological flexibility in a randomized controlled trial of an acceptance-based behavioral weight loss treatment. The relationships between change in these measures and weight loss outcomes were also examined. Adults (N = 283) were randomized to receive 12 months of acceptance-based (ABT) or non-acceptance-based (non-ABT) behavioral treatment and completed measures of general and weight control-specific psychological flexibility at months 0, 6, and 12. Participants in ABT demonstrated greater increases in psychological flexibility related to eating and physical activity experiences during treatment compared to participants in non-ABT, and changes in these processes were correlated with better weight loss. Parallel mediation analyses further revealed that psychological flexibility related to eating and physical activity experiences partially mediated the relationship between treatment condition and 12-month weight loss. Participants across conditions also experienced small increases in general psychological flexibility, but general psychological flexibility was not meaningfully related to weight loss outcomes. These findings indicate that domain-specific (versus general) psychological flexibility may be most impacted by ABT and most relevant to weight loss outcomes. Results also provide partial support for the theoretical model of ABT for weight management.
Collapse
Affiliation(s)
- Leah M Schumacher
- The Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA.,Department of Psychology, Drexel University, Philadelphia, PA
| | - Kathryn M Godfrey
- The Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA.,Department of Psychology, Drexel University, Philadelphia, PA
| | - Evan M Forman
- The Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA.,Department of Psychology, Drexel University, Philadelphia, PA
| | - Meghan L Butryn
- The Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA.,Department of Psychology, Drexel University, Philadelphia, PA
| |
Collapse
|
29
|
Abstract
OBJECTIVE Summarize and evaluate self-report measures of food craving, provide suggestions on future directions for the field of food craving measurement, and deliver guidance on how to select a food craving measure. METHODS Online bibliographical databases (PsycINFO and PubMed) were searched for peer-reviewed literature on self-report measures of food craving. RESULTS There is a wide selection of food craving measures that researchers and clinicians can use to assess state, past, and trait food cravings. Most questionnaires were tested on homogenous samples and their psychometric properties in older, male, and socioeconomically, racially, and ethnically diverse samples is largely unknown. Few questionnaires were tested in samples with overweight/obesity or eating disorders. Relatively few questionnaires adequately evaluate contextual factors that can trigger craving. There appears to be limited data on the predictive validity of food craving measures in regards to response to eating disorder treatment. A decision tree was provided to help researchers and clinicians select a food craving measure that is best suited to a particular clinical or research purpose. CONCLUSIONS It is recommended that researchers adequately assess the contextual factors that may trigger craving and the multi-sensory nature of craving for food. It would be beneficial for researchers to evaluate the psychometrics of food craving measures in more diverse samples (in terms of sex, race, ethnicity, socioeconomic status, weight status, and eating disorder psychopathology). More longitudinal studies should be conducted to provide information on the predictive validity of food craving measures regarding response to eating disorder treatment. Furthermore, it is suggested that researchers assess which tactics people use to reduce the frequency and strength of food cravings and restrain their consumption of craved foods.
Collapse
Affiliation(s)
- Maija Taylor
- Bowling Green State University, 822 East Merry Avenue, 200 Psychology Building, BOWLING GREEN, OH 43403-0232, United States.
| |
Collapse
|
30
|
Coffino JA, Heiss S, Hormes JM. Targeting acceptance in the management of food craving: The mediating roles of eating styles and thought suppression. Eat Behav 2018; 29:132-136. [PMID: 29665461 DOI: 10.1016/j.eatbeh.2018.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 04/06/2018] [Accepted: 04/11/2018] [Indexed: 11/29/2022]
Abstract
Food craving is now widely considered to be a cognitively motivated state. Acceptance-based treatments are effective in reducing the adverse impact of food cravings on consumption, via a hypothesized decrease in experiential avoidance. The mechanisms that drive the success of acceptance-based management of craving remain to be empirically tested. This study examined the role of eating styles and thought suppression as mediators in the relationship between experiential avoidance and craving. Participants (n = 298, 51.5% female) completed the Food Craving Acceptance and Awareness Questionnaire (FAAQ), the Dutch Eating Behavior Questionnaire (DEBQ), the White Bear Suppression Inventory (WBSI; a measure of thought suppression), and the reduced version of the Food Craving Questionnaire- Trait (FCQ-T-r). Scores on the FAAQ were inversely associated with scores on the FCQ-T-r, DEBQ, and WBSI; FCQ-T-r scores were positively correlated with scores on the DEBQ and WBSI (all p < 0.001). The total indirect effect of acceptance on craving through the hypothesized mediators was significantly different from zero. Controlling for eating styles and thought suppression, acceptance remained a significant predictor of craving. Results thus provide initial evidence that eating styles and thought suppression mediate the relationship between food-specific experiential avoidance and food craving. Findings lay the foundation for future study of the proximal antecedents of food cravings and lend preliminary support for targeting thought suppression and eating styles in acceptance-based approaches to the management of craving.
Collapse
Affiliation(s)
- Jaime A Coffino
- Department of Psychology, University at Albany, State University of New York, USA.
| | - Sydney Heiss
- Department of Psychology, University at Albany, State University of New York, USA
| | - Julia M Hormes
- Department of Psychology, University at Albany, State University of New York, USA
| |
Collapse
|
31
|
Bradley LE, Forman EM, Kerrigan SG, Goldstein SP, Butryn ML, Thomas JG, Herbert JD, Sarwer DB. Project HELP: a Remotely Delivered Behavioral Intervention for Weight Regain after Bariatric Surgery. Obes Surg 2017; 27:586-598. [PMID: 27586525 DOI: 10.1007/s11695-016-2337-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Weight regain following bariatric surgery is common and potentially compromises the health benefits initially attained after surgery. Poor compliance to dietary and physical activity prescriptions is believed to be largely responsible for weight regain. Patients may benefit from developing specialized psychological skills necessary to engage in positive health behaviors over the long term. Unfortunately, patients often face challenges to physically returning to the bariatric surgery program for support in developing and maintaining these behaviors. Remotely delivered interventions, in contrast, can be conveniently delivered to the patient and have been found efficacious for a number of health problems, including obesity. To date, they have received little attention with bariatric surgery patients. The study aimed to evaluate a newly developed, remote acceptance-based behavioral intervention for postoperative weight regain. METHODS Patients at least 1.5 years out from surgery who experienced postoperative weight regain were recruited to receive the 10-week intervention. Participants were assessed at baseline, mid-treatment, post-treatment, and at 3-month follow-up. RESULTS Support for the intervention's feasibility and acceptability was achieved, with 70 % retention among those who started the program and a high mean rating (4.7 out of 5.0) of program satisfaction among study completers. On average, weight regain was reversed with a mean weight loss of 5.1 ± 5.5 % throughout the intervention. This weight loss was maintained at 3-month follow-up. Significant improvements in eating-related and acceptance-based variables also were observed. CONCLUSIONS This pilot study provides initial support for the feasibility, acceptability, and preliminary efficacy of a remotely delivered acceptance-based behavioral intervention for postoperative weight regain.
Collapse
Affiliation(s)
- Lauren E Bradley
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 400, Chicago, IL, 60625, USA.
| | - Evan M Forman
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | | | | | - Meghan L Butryn
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - J Graham Thomas
- Weight Control and Diabetes Research Center, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - James D Herbert
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - David B Sarwer
- Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
| |
Collapse
|
32
|
A Pilot Study of an Acceptance-Based Behavioral Intervention for Weight Regain After Bariatric Surgery. Obes Surg 2017; 26:2433-41. [PMID: 26964997 DOI: 10.1007/s11695-016-2125-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Tens of thousands of bariatric surgery patients each year experience sub-optimal weight loss, significant regain, or both. Weight regain can contribute to a worsening of weight-related co-morbidities, and for some, leads to secondary surgical procedures. Poor weight outcomes have been associated with decreased compliance to the recommended postoperative diet. Decreased compliance may be partially due to a lack of psychological skills necessary to engage in healthy eating behaviors over the long term, especially as the effects of surgery (on appetite, hunger, and desire for food) decrease. Many behavioral interventions do not sufficiently address these challenges and often have limited effectiveness. The study aimed to evaluate the feasibility, acceptability, and preliminary effectiveness of a novel 10-week acceptance-based behavioral intervention to stop postoperative weight regain. METHODS A sample of bariatric surgery patients (n = 11) who regained at least 10 % of their maximum lost postoperative weight was recruited. All participants received the intervention, which emphasized psychological skills thought to be integral to successful weight control post-surgery. RESULTS The intervention was shown to be feasible and acceptable, with 72 % retention and high mean rating (4.25 out of 5.00) of program satisfaction among completers. Weight regain was stopped, and even reversed, with a mean total body weight loss of 3.58 ± 3.02 % throughout the 10-week intervention. There were also significant improvements in eating-related and acceptance-related variables. CONCLUSIONS These findings provide initial support for the use of a psychological acceptance-based intervention for weight regain in bariatric surgery patients.
Collapse
|
33
|
Martin LM, Espel-Huynh HM, Marando-Blanck S, Evans BC, Forman EM, Butryn ML, Baer RA, Wolever RQ, Herbert JD. Trusting homeostatic cues versus accepting hedonic cues: A randomized controlled trial comparing two distinct mindfulness-based intervention components. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017. [DOI: 10.1016/j.jcbs.2017.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
34
|
Levin ME, Pierce B, Schoendorff B. The acceptance and commitment therapy matrix mobile app: A pilot randomized trial on health behaviors. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017. [DOI: 10.1016/j.jcbs.2017.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
35
|
Yavuz F, Ulusoy S, Iskin M, Esen FB, Burhan HS, Karadere ME, Yavuz N. Turkish Version of Acceptance and Action Questionnaire-II (AAQ-II): A reliability and Validity Analysis in Clinical and Non-Clinical Samples. ACTA ACUST UNITED AC 2017. [DOI: 10.5455/bcp.20160223124107] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Fatih Yavuz
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, 5th Psychiatry Unit, Istanbul - Turkey
| | | | | | - Fatma Betul Esen
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, 2nd Psychiatry Unit, Istanbul - Turkey
| | - Huseyin Sehid Burhan
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, 5th Psychiatry Unit, Istanbul - Turkey
| | | | - Nuran Yavuz
- Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul - Turkey
| |
Collapse
|
36
|
Juarascio AS, Manasse SM, Espel HM, Schumacher LM, Kerrigan S, Forman EM. A Pilot Study of an Acceptance-based Behavioral Treatment for Binge Eating Disorder. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017; 6:1-7. [PMID: 28966910 PMCID: PMC5618713 DOI: 10.1016/j.jcbs.2016.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While existing treatments produce remission in a relatively large percentage of individuals with binge eating disorder (BED), room for improvement remains. Interventions designed to increase emotion regulation skills and clarify one's chosen values may be well-suited to address factors known to maintain BED. The current study examined the preliminary efficacy of a group-based treatment, Acceptance-based Behavioral Therapy (ABBT), in a small open trial (n=19), as well as the relationship between changes in hypothesized mechanisms of action and outcomes. ABBT includes the behavioral components of cognitive behavioral treatment for BED and emotion-focused strategies from acceptance and commitment therapy and dialectical behavioral therapy. Results from generalized linear multilevel modeling revealed significant fixed linear effects of time on depression, quality of life, global eating pathology, and binge frequency (all ps < .05). Global eating disorder symptoms appeared to improve rapidly from pre- to mid-treatment, and continued to improve toward post-treatment and follow-up, but at a slower rate. Binge frequency decreased rapidly from pre- to mid-treatment, followed by a slight increase at post-treatment and a reduction again by follow-up. Improvements in experiential acceptance were strongly and consistently related to decreases in overall eating pathology across several measures (rs = .35-.54). Additionally, greater access to emotion regulation strategies was strongly related to decreases in overall eating pathology (r= .67). Preliminary results support the efficacy of this novel treatment approach and indicate that additional research on ABBT for BED is warranted.
Collapse
Affiliation(s)
| | | | - Hallie M Espel
- Drexel University, Department of Psychology, Philadelphia PA
| | | | | | - Evan M Forman
- Drexel University, Department of Psychology, Philadelphia PA
| |
Collapse
|
37
|
Criscitelli K, Avena NM. The neurobiological and behavioral overlaps of nicotine and food addiction. Prev Med 2016; 92:82-89. [PMID: 27509870 DOI: 10.1016/j.ypmed.2016.08.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 08/01/2016] [Accepted: 08/06/2016] [Indexed: 12/19/2022]
Abstract
Both cigarette smoking and obesity are significant public health concerns and are associated with increased risk of early mortality. It is well established that the mesolimbic dopamine pathway is an important component of the reward system within the brain and is implicated in the development of addiction. Indeed, nicotine and highly palatable foods are capable of altering dopamine release within this system, engendering addictive like responses in susceptible individuals. Although additional research is warranted, findings from animal and human literature have elucidated many of neuroadaptions that occur from exposure to nicotine and highly palatable foods, leading to a greater understanding of the underlying mechanisms contributing to these aberrant behaviors. In this review we present the findings taken from preclinical and clinical literature of the known effects of exposure to nicotine and highly palatable foods on the reward related circuitry within the brain. Further, we compare the neurobiological and behavioral overlaps between nicotine, highly palatable foods and obesity. Lastly, we examine the stigma associated with smoking, obesity and food addiction, and the consequences stigma has on the overall health and wellbeing of an individual.
Collapse
Affiliation(s)
- Kristen Criscitelli
- Department of Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nicole M Avena
- Department of Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| |
Collapse
|
38
|
Lower Experiential Avoidance Is Associated With Psychological Well-being and Improved Cardiopulmonary Endurance Among Patients in Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2016; 36:438-444. [DOI: 10.1097/hcr.0000000000000182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
39
|
Forman EM, Butryn ML, Manasse SM, Crosby RD, Goldstein SP, Wyckoff EP, Thomas JG. Acceptance-based versus standard behavioral treatment for obesity: Results from the mind your health randomized controlled trial. Obesity (Silver Spring) 2016; 24:2050-6. [PMID: 27670400 PMCID: PMC5051349 DOI: 10.1002/oby.21601] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the efficacy, as well as potential moderators and mediators, of a revised acceptance-based behavioral treatment (ABT) for obesity, relative to standard behavioral treatment (SBT). METHODS Participants with overweight and obesity (n = 190) were randomized to 25 sessions of ABT or SBT over 1 year. Primary outcome (weight), mediator, and moderator measurements were taken at baseline, 6 months, and/or 12 months, and weight was also measured every session. RESULTS Participants assigned to ABT attained a significantly greater 12-month weight loss (13.3% ± 0.83%) than did those assigned to SBT (9.8% ± 0.87%; P = 0.005). A condition by quadratic time effect on session-by-session weights (P = 0.01) indicated that SBT had a shallower trajectory of weight loss followed by an upward deflection. ABT participants were also more likely to maintain a 10% weight loss at 12 months (64.0% vs. 48.9%; P = 0.04). No evidence of moderation was found. Results supported the mediating role of autonomous motivation and psychological acceptance of food-related urges. CONCLUSIONS Behavioral weight loss outcomes can be improved by integrating self-regulation skills that are reflected in acceptance-based treatment, i.e., tolerating discomfort and reduction in pleasure, enacting commitment to valued behavior, and being mindfully aware during moments of decision-making.
Collapse
Affiliation(s)
- Evan M Forman
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA.
| | - Meghan L Butryn
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie M Manasse
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | | | - Emily P Wyckoff
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| |
Collapse
|
40
|
Caught in the struggle with food craving: Development and validation of a new cognitive fusion measure. Appetite 2016; 101:146-55. [DOI: 10.1016/j.appet.2016.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 02/28/2016] [Accepted: 03/01/2016] [Indexed: 11/19/2022]
|
41
|
Ruiz FJ, Suárez-Falcón JC, Cárdenas-Sierra S, Durán Y, Guerrero K, Riaño-Hernández D. Psychometric Properties of the Acceptance and Action Questionnaire–II in Colombia. PSYCHOLOGICAL RECORD 2016. [DOI: 10.1007/s40732-016-0183-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
42
|
Schaumberg K, Schumacher LM, Rosenbaum DL, Kase CA, Piers AD, Lowe MR, Forman EM, Butryn ML. The role of negative reinforcement eating expectancies in the relation between experiential avoidance and disinhibition. Eat Behav 2016; 21:129-34. [PMID: 26854594 PMCID: PMC4856013 DOI: 10.1016/j.eatbeh.2016.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 01/09/2016] [Accepted: 01/19/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Eating-related disinhibition (i.e., a tendency to overeat in response to various stimuli) is associated with weight gain and poorer long-term weight loss success. Theoretically, experiential avoidance (i.e., the desire or attempts to avoid uncomfortable internal experiences), may predispose individuals to developing negative reinforcement eating expectancies (i.e., the belief that eating will help to mitigate distress), which in turn promote disinhibition. Such relationships are consistent with an acquired preparedness model, which posits that dispositions influence learning and subsequent behavior. Drawing from this framework, the current study represents the first investigation of relations between negative reinforcement eating expectancies, experiential avoidance (both general and food-specific) and disinhibited eating. In particular, the mediating role of negative reinforcement eating expectancies in the relation between experiential avoidance and disinhibited eating was examined. METHOD Participants (N=107) were overweight and obese individuals presenting for behavioral weight loss treatment who completed measures of general and food-related experiential avoidance, negative reinforcement eating expectancies, and disinhibition. RESULTS Experiential avoidance and negative reinforcement eating expectancies significantly related to disinhibition. Furthermore, the relation between experiential avoidance and disinhibition was mediated by negative reinforcement eating expectancies. DISCUSSION The current study supports an acquired preparedness model for disinhibition, such that the relation between experiential avoidance and disinhibition is accounted for by expectations that eating will alleviate distress. Findings highlight the potential role of eating expectancies in models accounting for obesity risk, and identify negative reinforcement eating expectancies as a potential treatment target for reducing disinhibition.
Collapse
|
43
|
|
44
|
Chang WH, Chi L, Lin SH, Ye YC. Psychometric Properties of the Acceptance and Action Questionnaire – II for Taiwanese College Students and Elite Athletes. CURRENT PSYCHOLOGY 2015. [DOI: 10.1007/s12144-015-9395-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
45
|
Barclay KS, Rushton PW, Forwell SJ. Measurement properties of eating behavior self-assessment tools in adult bariatric surgery populations: a systematic review. Obes Surg 2015; 25:720-37. [PMID: 25691348 DOI: 10.1007/s11695-015-1593-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The present study aims to identify the range of eating behavior self-assessment tools reported in the adult bariatric surgery literature and evaluate the measurement properties of these tools using pre-established criteria. This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. This review revealed the use of 20 distinct tools; however, evidence for measurement properties specific to bariatric surgery populations was limited to only ten of these tools, as reported in 14 papers. Validity varied extensively and there was a widespread lack of information regarding measurement of change over time and patient burden. According to the evaluation criteria, there was adequate support for two tools. Several other tools show potential but would benefit from additional investigation of their measurement properties prior to continued use with bariatric surgery patients.
Collapse
Affiliation(s)
- Karen S Barclay
- Mental Health and Addictions, Vancouver Coastal Health, Vancouver, British Columbia, Canada,
| | | | | |
Collapse
|
46
|
Spatola CAM, Cappella EAM, Goodwin CL, Baruffi M, Malfatto G, Facchini M, Castelnuovo G, Manzoni GM, Molinari E. Development and initial validation of the Cardiovascular Disease Acceptance and Action Questionnaire (CVD-AAQ) in an Italian sample of cardiac patients. Front Psychol 2014; 5:1284. [PMID: 25452737 PMCID: PMC4231832 DOI: 10.3389/fpsyg.2014.01284] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 10/23/2014] [Indexed: 11/20/2022] Open
Abstract
Psychological inflexibility refers to the attempt to decrease internal distress even when doing so is inconsistent with life values, and has been identified as a potential barrier to making and maintaining health behavior changes that are consistent with a heart-healthy lifestyle. Disease- and behavior-specific measures of psychological inflexibility have been developed and utilized in treatment research. However, no specific measure has been created for patients with heart disease. Thus, the CardioVascular Disease Acceptance and Action Questionnaire (CVD-AAQ) was developed. The present study is aimed to evaluate the psychometric properties of the CVD-AAQ and to explore its association with measures of psychological adjustment and cardiovascular risk factors in an Italian sample of 275 cardiac patients. Exploratory factor analysis showed a structural one-factor solution with satisfactory internal consistency and test-retest reliability. The relation with other measures was in the expected direction with stronger correlations for the theoretically consistent variables, supporting convergent and divergent validity. CVD-AAQ scores were associated with general psychological inflexibility, anxiety and depression and inversely correlated with psychological well-being. Moreover, the results showed that CVD-AAQ scores are associated with two relevant risk factors for cardiac patients, namely low adherence to medication and being overweight. In sum, results suggest that the CVD-AAQ is a reliable and valid measure of heart disease-specific psychological inflexibility with interesting clinical applications for secondary prevention care.
Collapse
Affiliation(s)
- Chiara A. M. Spatola
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Emanuele A. M. Cappella
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | | | - Matteo Baruffi
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Gabriella Malfatto
- Cardiology Division, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
| | - Mario Facchini
- Cardiology Division, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Faculty of Psychology, eCampus UniversityNovedrate, Como, Italy
| | - Enrico Molinari
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| |
Collapse
|
47
|
Measuring the Ability to Tolerate Activity-Related Discomfort: Initial Validation of the Physical Activity Acceptance Questionnaire (PAAQ). J Phys Act Health 2014; 12:717-6. [PMID: 25106049 DOI: 10.1123/jpah.2013-0338] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical activity (PA) is essential for health, but many adults find PA adherence challenging. Acceptance of discomfort related to PA may influence an individual's ability to begin and sustain a program of exercise. The aim of this study was to evaluate the psychometric properties of the Physical Activity Acceptance Questionnaire (PAAQ). METHODS The PAAQ was administered to 3 distinct samples (N = 418). Each sample completed additional self-report measures; 1 sample also wore accelerometers for 7 days (at baseline and 6 months later). RESULTS The PAAQ demonstrated high internal validity for its total score (α = .89) and 2 subscales (Cognitive Acceptance α = .86, Behavioral Commitment α = .85). The PAAQ also showed convergent validity with measures of mindfulness, self-reported physical activity levels, and accelerometer-verified levels of moderate-to-vigorous PA (MVPA; P-values < .05). The Cognitive Acceptance subscale showed predictive validity for objectively-verified PA levels among individuals attempting to increase PA over 6 months (P = .05). Test-retest reliability for a subset of participants (n = 46) demonstrated high consistency over 1 week (P < .0001). CONCLUSIONS The PAAQ demonstrates sound psychometric properties, and shows promise for improving the current understanding of PA facilitators and barriers among adults.
Collapse
|
48
|
Timko CA, Juarascio AS, Martin LM, Faherty A, Kalodner C. Body image avoidance: An under-explored yet important factor in the relationship between body image dissatisfaction and disordered eating. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2014. [DOI: 10.1016/j.jcbs.2014.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
49
|
Levin ME, Dalrymple K, Himes S, Zimmerman M. Which facets of mindfulness are related to problematic eating among patients seeking bariatric surgery? Eat Behav 2014; 15:298-305. [PMID: 24854822 DOI: 10.1016/j.eatbeh.2014.03.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 01/09/2014] [Accepted: 03/11/2014] [Indexed: 11/19/2022]
Abstract
There has been growing research indicating the potential positive benefits of mindfulness-based interventions for obesity, but few studies have examined the relationship of mindfulness processes to obesity-related behaviors, particularly among clinical populations such as bariatric surgery candidates. The current study examined the relationship of specific mindfulness facets to a variety of problematic eating behaviors assessed through diagnostic interviews in a clinical sample of 820 patients seeking bariatric surgery. Results indicated that greater mindfulness on specific facets, particularly acting with awareness, was related to less binge and emotional eating. Greater mindfulness was also related, though less consistently, to less habitual overeating and grazing. The observing facet was generally unrelated to problematic eating, but in a few cases being more observant related to having greater eating problems. The results of the study and future directions are discussed in relation to research on problematic eating in obesity and mindfulness-based interventions.
Collapse
Affiliation(s)
- Michael E Levin
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Utah State University, Department of Psychology, Logan, UT, USA.
| | - Kristy Dalrymple
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
| | - Susan Himes
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
| | - Mark Zimmerman
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
| |
Collapse
|
50
|
Katterman SN, Goldstein SP, Butryn ML, Forman EM, Lowe MR. Efficacy of an acceptance-based behavioral intervention for weight gain prevention in young adult women. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2014. [DOI: 10.1016/j.jcbs.2013.10.003] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|