Acceptance Based Behavioral Intervention for Weight Loss: A Randomized Trial

NCT ID: NCT01461421

Last Updated: 2017-04-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-07-31

Study Completion Date

2017-03-31

Brief Summary

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The proposed project is testing two behavioral interventions designed to improve long-term weight loss among participants who struggle with eating in response to stress or emotional experiences. Group treatment lasts for 1 year, with assessments lasting 2 years. Participants must live in the greater Providence, Rhode Island area in order to be eligible.

Detailed Description

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Obesity is a major health problem and behavioral weight control programs are the treatment of choice for mild and moderate obesity. However, there is marked variability among participants in the weight losses achieved in these programs and the maximum weight losses are typically achieved at month 6, followed by weight regain. Thus innovative approaches are needed to improve longer-term treatment outcomes.

Currently, the same behavioral treatment program is offered to all participants, with no tailoring to meet the needs of specific subgroups. One subgroup that may need a specialized approach are those who report high levels of internal disinhibition, i.e. eating in response to negative thoughts or emotions. Over 50% of individuals entering behavioral weight loss programs report high levels of internal disinhibition on the Eating Inventory (EI), this subgroup is distinct from those with binge eating disorder, and most importantly, these individuals lose significantly less weight than other participants during weight loss treatment \[particularly at 18 months\]. Thus efforts are needed to develop more effective treatments for this subgroup. The proposed research is significant because it may help move the field from a "one size fits all" approach, to the development of interventions for specific subgroups of the population.

The investigators hypothesize that individuals who report problems with internal disinhibition may achieve better weight losses in an enhanced behavioral weight loss program that focuses on acceptance-based strategies. Whereas standard behavioral treatments teach patients to control their negative thoughts with techniques such as cognitive restructuring and distraction, acceptance based strategies teach patients to experience thoughts and feelings as they are, without attempting to control them and to continue to pursue their behavioral goals despite experiencing negative thoughts and feelings. Acceptance-based strategies have been shown to be helpful for a number of behavioral problems including weight loss and maintenance, however are yet untested in large trials.

The current study is a randomized controlled trial comparing standard behavioral weight loss treatment with a program which incorporates acceptance based strategies in the treatment of overweight/obese individuals with problems with internal disinhibition. A total of 160 participants will be randomly assigned to a standard behavioral weight loss treatment program (SBT) or to an innovative approach that combines standard behavioral weight loss with acceptance based strategies (referred to hereafter as "Acceptance Based Behavioral Intervention" or ABBI). Both groups will meet weekly for 6 months, biweekly for 3 months and then monthly for 3 months. Assessments will be conducted at baseline and 6 month intervals for 24 months total, with measures of weight, acceptance of negative emotions, distress tolerance, and adherence to the weight loss program.

The primary hypothesis is that participants in the ABBI program will achieve greater changes in weight (in the form of weight reductions) at 6, 12, 18, and 24 months when compared to baseline weight than participants in SBT. Secondary hypotheses are that participants in ABBI will experience greater improvements in acceptance of weight related negative thoughts and emotions and distress tolerance and better treatment adherence than participants in SBT.

Conditions

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Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard Behavioral Treatment

Nutrition education, behavioral weight loss techniques, and standard cognitive strategies for dealing with stress and emotions. Six months weekly, 3 months bi-weekly, 3 months monthly.

Group Type ACTIVE_COMPARATOR

Nutrition Education

Intervention Type BEHAVIORAL

Participants are taught about energy balance, caloric intake, the nutrition content of foods, and diet.

Behavioral Weight Loss Strategies

Intervention Type BEHAVIORAL

Participants are taught self-monitoring and goal setting techniques.

Standard Cognitive Techniques

Intervention Type BEHAVIORAL

Participants are taught how to modify, get rid of, or distract from thoughts and also how to regulate emotions.

Acceptance Based Behavioral Intervention

Nutrition education, behavioral weight loss techniques, and acceptance based strategies for dealing with stress and emotions. Six months weekly, 3 months bi-weekly, 3 months monthly.

Group Type EXPERIMENTAL

Nutrition Education

Intervention Type BEHAVIORAL

Participants are taught about energy balance, caloric intake, the nutrition content of foods, and diet.

Behavioral Weight Loss Strategies

Intervention Type BEHAVIORAL

Participants are taught self-monitoring and goal setting techniques.

Acceptance Based Techniques

Intervention Type BEHAVIORAL

Participants are taught how to accept and change their perception of their thoughts and emotions.

Interventions

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Nutrition Education

Participants are taught about energy balance, caloric intake, the nutrition content of foods, and diet.

Intervention Type BEHAVIORAL

Behavioral Weight Loss Strategies

Participants are taught self-monitoring and goal setting techniques.

Intervention Type BEHAVIORAL

Standard Cognitive Techniques

Participants are taught how to modify, get rid of, or distract from thoughts and also how to regulate emotions.

Intervention Type BEHAVIORAL

Acceptance Based Techniques

Participants are taught how to accept and change their perception of their thoughts and emotions.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Must live in the greater Providence, RI area and be able to attend treatment sessions on site for 1 year
* BMI between 30-50
* Age between 18-70
* meets clinical cutoff on Internal Disinhibition sub-scale of the Eating Inventory

Exclusion Criteria

* report a heart condition, chest pain during periods of activity or rest, or loss of consciousness
* physically unable to exercise
* are currently pregnant or plan to become pregnant in the next 24 months
* are planning to move outside the state within the next 24 months
* Cancer diagnoses in the past 5 years
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Miriam Hospital

OTHER

Sponsor Role lead

Responsible Party

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Rena R. Wing

Director Weight Control & Diabetes Research Center

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rena R. Wing, PhD

Role: PRINCIPAL_INVESTIGATOR

The Miriam Hospital

Locations

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The Miriam Hospital

Providence, Rhode Island, United States

Site Status

Countries

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United States

References

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Lillis J, Niemeier HM, Ross KM, Thomas JG, Leahey T, Unick J, Kendra KE, Wing RR. Weight loss intervention for individuals with high internal disinhibition: design of the Acceptance Based Behavioral Intervention (ABBI) randomized controlled trial. BMC Psychol. 2015 May 28;3(1):17. doi: 10.1186/s40359-015-0075-2. eCollection 2015.

Reference Type DERIVED
PMID: 26019869 (View on PubMed)

Other Identifiers

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1R01DK087704-01A1

Identifier Type: NIH

Identifier Source: org_study_id

View Link

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