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Cited by 366Mindfulness and Compassion InterventionsEating Disorders and BehaviorsNutrition, Health and Food Behavior

Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women

Tapper, Katy, Shaw, Christine, Ilsley, Joanne, Hill, Andrew J., Bond, Frank W., Moore, Laurence·2009·Appetite
DOI 10.1016/j.appet.2008.11.012
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Abstract

To explore the efficacy of a mindfulness-based weight loss intervention for women. Sixty-two women (ages 19-64; BMI 22.5-52.1) who were attempting to lose weight were randomised to an intervention or control condition. The former were invited to attend four 2-h workshops, the latter were asked to continue with their normal diets. Data were collected at baseline, 4 and 6 months. BMI, physical activity, mental health. At 6 months intervention participants showed significantly greater increases in physical activity compared to controls (p<.05) but no significant differences in weight loss or mental health. However, when intervention participants who reported 'never' applying the workshop principles at 6 months (n=7) were excluded, results showed both significantly greater increases in physical activity (3.1 sessions per week relative to controls, p<.05) and significantly greater reductions in BMI (0.96 relative to controls, equivalent to 2.32 kg, p<0.5). Reductions in BMI were mediated primarily by reductions in binge eating. Despite its brevity, the intervention was successful at bringing about change. Further refinements should increase its efficacy.

AI snapshot

Written from the paper’s full text.

TL;DR

This exploratory RCT tested a brief mindfulness/ACT-based weight-loss intervention in 62 women attempting to lose weight. At 6 months it significantly increased physical activity but did not significantly improve BMI or mental health overall; BMI reductions appeared when participants who never applied the principles were excluded, and these reductions were mediated primarily by reduced binge eating.

Key findings

  • In intention-to-treat analysis, there was no significant intervention effect on BMI, F(1, 60)=1.59, p=.21, or mental health difficulties, F(1, 60)=1.29, p=.26, but a significant effect on physical activity, F(1, 60)=6.63, p<.013.
  • In the intervention-efficacy analysis excluding non-attenders, intervention participants showed significantly greater increases in physical activity, t(44)=2.46, p=.018, but no significant BMI difference, t(45)=1.40, p=.17.
  • Excluding intervention participants who reported “never” applying workshop principles at 6 months (n=7), BMI reductions were significantly greater in the intervention group, t(38)=2.24, p=.031, equivalent to 2.32 kg relative to controls, and physical activity increases were significantly greater, t(38)=2.36, p=.023.
  • BMI change was mediated primarily by reductions in binge eating: BMI change correlated with binge-eating change (0.45, p<.05), and hierarchical regression suggested the intervention effect on BMI was largely, but not wholly, brought about by reductions in binge eating.

Methods

  • Randomised controlled trial of 62 women aged 19–64 with BMI 22.5–52.1 who were attempting to lose weight; participants were stratified by BMI and medical conditions and allocated to an intervention or control condition.
  • Intervention participants were invited to four 2-hour mindfulness/ACT-based workshops over three consecutive weeks plus a follow-up session about three months later; controls were asked to continue their normal diets. Data were collected at baseline, 4 months, and 6 months.
  • Main outcomes were BMI, physical activity (BPAT), and mental health (GHQ-12); hypothesised mediators included emotional/external eating (DEBQ), emotional eating (EEQ), binge eating (BES), acceptance/action (AAQ-II), and dietary adherence. Analyses included intention-to-treat MANOVA, follow-up tests, efficacy analyses excluding non-attenders, correlations, and hierarchical regression for mediation.

Limitations

  • The paper states it was an exploratory trial; future evaluations should include a standard rather than no-treatment control, extend beyond 6 months, and account for clustering effects because the intervention was delivered in groups.
  • The paper also states the intervention and control groups were not well-matched for physical activity and binge eating at baseline, so results for these variables need replication.
  • Evident from the text: the sample was small (62 randomised; efficacy analyses used 23 intervention and 24 controls; moderator analysis used 16 intervention and 24 controls), and several mediator/moderator measures relied on self-report.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.appet.2008.11.012

Cites

46 of 46 references verified0 citation errors · 0 not checkable

Statistics

9 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

0 of 45 cited sources checked · 0 supported · 0 flagged

  • Findingown data
    § Abstract · p. 3

    At 6 months, there were no significant differences between intervention and control in mental health.

    “but no significant differences in weight loss or mental health”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Abstract · p. 3

    At 6 months, there were no significant differences between intervention and control in weight loss.

    “but no significant differences in weight loss or mental health”
    Quote in the paperSubstantial claim
  • Findingown data
    § Abstract · p. 3

    At 6 months, intervention participants showed significantly greater increases in physical activity compared to controls (p<.05).

    “At 6 months intervention participants showed significantly greater increases in physical activity compared to controls (p&lt;.05)”
    Quote in the paperSubstantial claim
  • Findingown data
    § Abstract · p. 3

    When intervention participants who reported 'never' applying the workshop principles at 6 months (n=7) were excluded, results showed significantly greater increases in physical activity (3.1 sessions per week relative to controls, p<.05).

    “However, when intervention participants who reported 'never' applying the workshop principles at 6 months (n=7) were excluded, results showed both significantly greater increases in physical activity (3.1 sessions per week relative to controls, p&lt;.05)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Excluding intervention participants who reported 'never' applying the workshop principles at 6 months yields a valid estimate of intervention efficacy.
  • Findingown data
    § Abstract · p. 3

    When those participants were excluded, results showed significantly greater reductions in BMI (0.96 relative to controls, equivalent to 2.32kg, p<0.5).

    “and significantly greater reductions in BMI (0.96 relative to controls, equivalent to 2.32kg, p&lt;0.5)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Excluding intervention participants who reported 'never' applying the workshop principles at 6 months yields a valid estimate of intervention efficacy.
  • May combine two claims. 29
  • The quote only partly states this claim. 4
  • Classified as probably not a substantial claim. 22

  • May combine two claims.

    Findingown data
    § Mediators · p. 19

    Intervention participants showed a greater reduction in binge eating compared to control participants, but there were no other significant differences among the mediator variables.

    “intervention participants showed a greater reduction in binge eating compared to control participants but there were no other significant differences.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Discussion · p. 21

    Qualitative data suggested that the most successful part was the cognitive defusion component, with participants finding it particularly useful in relation to exercise.

    “Qualitative data suggested that the most successful part was the cognitive defusion component, with participants finding it particularly useful in relation to exercise.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § Moderators · p. 18

    In the re-analysis excluding never users, mean physical activity change was 2.50 (SD 4.88) for intervention participants and -0.61 (SD 3.34) for controls.

    “2.50 (4.88) and -0.61 (3.34) respectively for physical activity”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data
    § Discussion · p. 21

    Intervention participants showed a relative increase in physical activity of 2.81 sessions per week at 6 months.

    “and showing a relative increase in physical activity of 2.81 sessions per week.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § Intervention efficacy · p. 17

    In per-protocol analysis, effect sizes for changes over 6 months were small for BMI and GHQ and moderate for physical activity.

    “Effect sizes for changes over the 6 month duration were small for BMI and GHQ and moderate for physical activity (see Table 4).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Excluding intervention participants who reported 'never' applying the workshop principles at 6 months yields a valid estimate of intervention efficacy.

  • The quote only partly states this claim.

    Findingown data
    § Moderators · p. 18

    Relative reductions in BMI in the workshop condition were equivalent to 2.32 kg in the re-analysis excluding never users.

    “Relative reductions in BMI in the workshop condition were equivalent to 2.32kg.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Discussion · p. 21

    The intervention had no significant impact on emotional eating, external eating, or psychological flexibility.

    “the intervention had no significant impact on emotional eating, external eating or psychological flexibility.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data
    § INSERT TABLE 4 HERE · p. 17

    In intention-to-treat follow-up tests, there was no significant effect of the intervention on BMI, F(1,60)=1.59, p=0.21.

    “These showed no significant effect of the intervention on BMI, F(1, 60) = 1.59, p = 0.21”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Missing data are missing at random, so that replacing missing values with the mean change from the control group is valid.

  • May combine two claims.

    Findingown data
    § Discussion · p. 21

    When data were re-analysed excluding those who reported 'never' using the workshop techniques at 6 months, the BMI difference rose to 2.32 kg and the physical activity difference rose to 3.11 activity sessions per week.

    “When the data were re-analysed excluding those who reported 'never' using the workshop techniques at 6 months these figures rose to 2.32kg and 3.11 activity sessions per week.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § INSERT TABLE 5 HERE · p. 19

    For BMI change, there were significant correlations with change in DEBQ emotional eating (r=0.35, p<.05) and binge eating (r=0.45, p<.05).

    “For BMI change results showed significant correlations with change in DEBQ emotional eating (0.35, p&lt;.05) and binge eating (0.45, p&lt;.05)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Intention to treat analysis · p. 16

    In intention-to-treat analysis, all means were in the predicted directions: BMI decreased in the intervention group relative to control, physical activity increased in intervention compared to a reduction in control, and recent mental health difficulties decreased in intervention and increased in control.

    “All means were in the predicted directions with BMI going down in the intervention group relative to the control group, physical activity showing an increase in the intervention group compared to a reduction in the control group and recent mental heath difficulties going down in the intervention group and up in the control group (see Table 4).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Missing data are missing at random, so that replacing missing values with the mean change from the control group is valid.

  • May combine two claims.

    Findingown data
    § Intervention efficacy · p. 17

    In per-protocol analysis, relative reductions in BMI in the intervention condition were equivalent to 1.35kg and increases in physical activity equivalent to 2.8 sessions.

    “Relative reductions in BMI in the intervention condition were equivalent to 1.35kg and increases in physical activity equivalent to 2.8 sessions.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Excluding intervention participants who reported 'never' applying the workshop principles at 6 months yields a valid estimate of intervention efficacy.

  • May combine two claims.

    Findingown data
    § Intention to treat analysis · p. 16

    In intention-to-treat analysis, changes for BMI and mental health were relatively minor with small treatment effect sizes, while physical activity showed a slightly larger change with a moderate treatment effect size.

    “However, the changes for BMI and mental health were relatively minor with small treatment effect sizes. Physical activity showed a slightly larger change with a moderate treatment effect size (see Table 4).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Missing data are missing at random, so that replacing missing values with the mean change from the control group is valid.

  • The quote only partly states this claim.

    Findingown data
    § INSERT TABLE 4 HERE · p. 17

    In intention-to-treat analysis, a one-way MANOVA showed a trend towards significance, F(1,58)=2.31, p=.086.

    “Results showed a trend towards significance, F (1, 58) = 2.31, p = .086.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Missing data are missing at random, so that replacing missing values with the mean change from the control group is valid.

  • Classified as probably not a substantial claim.

    Premisecitation
    § Introduction · p. 5

    In these cases, ACT appeared to be as or more effective than traditional approaches for maintenance of behavioural changes.

    “Of particular note is that in these cases ACT appeared to be as or more effective than traditional approaches when it came to the maintenance of behavioural changes (Gifford et al., 2004; Hayes, Wilson et al., 2004).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Gifford et al., 2004 source

      Not checked in the free run.

    • cites Hayes, Wilson et al., 2004

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning
    § Introduction · p. 6

    If emotional eating is an attempt to distract from or alleviate negative feelings, it can be viewed as a form of experiential avoidance.

    “If this is the case, emotional eating can be viewed as a form of experiential avoidance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § Introduction · p. 6

    Obesity is associated with both emotional eating and external eating.

    “There is evidence to suggest that obesity is associated with both emotional eating and external eating .”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Blair, Lewis &amp; Booth, 1990 source

      Not checked in the free run.

    • cites Braet &amp; Van Strien, 1997

      Not checked in the free run.

    • cites Wardle, 1987 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Introduction · p. 4

    The development of interventions incorporating psychological components falls far short of that achieved in areas such as nicotine and alcohol dependence.

    “Although a growing number of interventions are now incorporating components aimed at this (e.g., Cooper &amp; Fairburn, 2001; Rapoport, Clark &amp; Wardle, 2000), the development of these still falls far short of that achieved in areas such as nicotine and alcohol dependence to which obesity has been compared (House of Commons Health Committee, 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites House of Commons Health Committee, 2004

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning
    § Introduction · p. 4

    Knowing how to lose weight is not sufficient; we also need to tackle the psychological processes that lead to behaviours associated with weight gain.

    “Thus knowing how to lose weight is simply not sufficient, we also need to tackle the psychological processes that lead to behaviours associated with weight gain.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation
    § Introduction · p. 4

    Experts are increasingly recognising the need to address the psychological aspects of obesity.

    “Indeed, experts are increasingly recognising the need to address the psychological aspects of obesity (e.g., Byrne, 2002; Cooper &amp; Fairburn, 2001; House of Commons Health Committee, 2004).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Byrne, 2002 source

      Not checked in the free run.

    • cites Cooper &amp; Fairburn, 2001

      Not checked in the free run.

    • cites House of Commons Health Committee, 2004

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § Introduction · p. 6

    In Blair et al. (1990), successful weight control was associated with decreases in emotional eating between baseline and 1-year follow-up and with low levels of emotional eating at both time points.

    “In addition, a study by Blair et al., (1990) found significant associations between levels of emotional eating and weight loss success; successful weight control was associated with decreases in emotional eating between baseline and a 1 year follow-up and with low levels of emotional eating at both time points.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Blair et al., (1990) source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation
    § Introduction · p. 6

    In Blair et al. (1990), unsuccessful weight control was associated with increases in emotional eating between baseline and follow-up and with high levels at both time points.

    “In contrast, unsuccessful weight control was associated with increases between baseline and follow-up and with high levels at both time points.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Blair et al., (1990) source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given
    § Study design and randomisation · p. 9

    KT was not involved in recruitment and was blind to participant identities.

    “KT was not involved in recruitment and was blind to participant identities.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data
    § Workshop attendance · p. 16

    Nearly half the sample (48%) attended all four workshops, and three-quarters (74%) attended two of the four workshops.

    “Nearly half the sample (48%) attended all four workshops whilst three-quarters (74%) attended two of the four workshops.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning
    § Study design and randomisation · p. 9

    Participants were allocated to intervention and control conditions using a stratified randomisation protocol on the basis of BMI and the existence of medical conditions likely to affect weight.

    “Participants were allocated to the intervention and control conditions using a stratified randomisation protocol on the basis of BMI and the existence of medical conditions likely to effect weight (since these variables were considered most likely to influence study outcomes).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data
    § Study design and randomisation · p. 10

    There were no significant differences between intervention and control groups at baseline in BMI, age, level of education, percentage with medical conditions affecting weight, percentage attending formal slimming clubs, number of previous diet attempts, or length spent on current diet.

    “As shown, there were no significant differences in BMI, age (though intervention participants were, on average, slightly older than control participants), level of education, % of participants with medical conditions affecting their weight, % of participants attending formal slimming clubs, number of previous diet attempts, or length spent on current diet.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Measures · p. 14

    The AAQ-II has good construct, concurrent, predictive and discriminant validity.

    “The AAQ-II has been shown to have good construct, concurrent, predictive and discriminant validity (Bond et al., submitted).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bond et al., submitted

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data
    § Discussion · p. 21

    The intervention group reported higher levels of binge eating and lower levels of physical activity at baseline, and the intervention and control groups were not well-matched for physical activity and binge eating at baseline.

    “the intervention group reported higher levels of binge eating, and lower levels of physical activity, at baseline”
    • Also stated in: § Discussion · p. 23 · plain
      “the intervention and control groups were not well-matched for physical activity and binge eating at baseline.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data
    § Workshop attendance · p. 16

    Attendance was highest at the start of the programme for Workshops 1 and 2 (n=25 and 24 respectively) and dropped off for Workshops 3 and 4 (n=18 and 16 respectively).

    “Attendance was highest at the start of the programme for Workshops 1 and 2 (n=25 and 24 respectively) and dropped off for Workshops 3 and 4 (n=18 and 16 respectively).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data
    § Workshop attendance · p. 16

    Of the 31 people randomised to the workshop condition, 26 attended one or more workshops, 1 attended half a workshop, and 4 failed to attend any workshops.

    “Of the 31 people randomised to the workshop condition, 26 attended one or more of the workshops, 1 attended half a workshop and 4 failed to attend any workshops.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given
    § Discussion · p. 23

    The present study was designed as an exploratory trial only.

    “the present study was designed as an exploratory trial only”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data
    § INSERT TABLE 2 HERE · p. 11

    Eight of the 12 workshops were observed by either KT or CS, and no problems relating to treatment integrity were identified.

    “JI, KT and CS had all attended a range of ACT training workshops and, as an informal assessment of treatment integrity, eight of the 12 workshops were observed by either KT or CS. During these sessions no problems relating to treatment integrity were identified.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given
    § Measures · p. 15

    All data were collected by assistants who were blind to participant group allocation and otherwise uninvolved in the project.

    “All data were collected by assistants who were blind to participant group allocation and who were otherwise uninvolved in the project.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data
    § Discussion · p. 21

    Qualitative data suggested that intervention participants coped better after breaking their diet, which may have helped interrupt previous patterns of diet lapses leading to binge eating episodes.

    “qualitative data suggested that intervention participants coped better after breaking their diet (for example by avoiding prolonged feelings of guilt and thoughts of failure) which may have helped interrupt previous patterns of diet lapses leading to binge eating episodes (Ogden &amp; Wardle, 1991).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ogden & Wardle, 1991

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Measures · p. 13

    The BPAT has moderate test-retest reliability; fair to moderate concurrent validity and poor to fair criterion validity.

    “It has been shown to have moderate testretest reliability; fair to moderate concurrent validity and poor to fair criterion validity (Smith et al., 2005).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Smith et al., 2005 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Measures · p. 13

    The DEBQ has satisfactory to good reliability, excellent factorial validity, and satisfactory concurrent and discriminant validity.

    “The DEBQ has been shown to have satisfactory to good reliability, excellent factorial validity and satisfactory concurrent and discriminant validity (Van Strien et al., 1986; Wardle, 1987).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Van Strien et al., 1986 source

      Not checked in the free run.

    • cites Wardle, 1987 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation
    § Study design and randomisation · p. 9

    Computer-generated random numbers were used to order intervention and control group allocation within each block.

    “Following Pocock (1983), computer-generated random numbers were used to order intervention and control group allocation within each block.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Pocock (1983)

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data
    § Measures · p. 14

    The EEQ had moderate internal reliability at baseline (alpha=0.47, n=62) but acceptable internal reliability (alpha=0.62) with the exclusion of item 6.

    “Internal reliability was moderate at baseline (alpha=0.47, n=62) but acceptable (alpha=0.62) with the exclusion of item 6 (happiness). Thus item 6 was excluded from all subsequent analyses.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationnone given
    § Introduction · p. 7

    Failure to adhere to exercise and healthy eating plans may be prompted by rationalisations about being more conscientious the next day or exceptional circumstances justifying relapse.

    “Likewise, failure to adhere to exercise and healthy eating plans may be prompted by rationalisations about, for example, being more conscientious the next day or there being exceptional circumstances that justify the relapse.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given
    § Study design and randomisation · p. 9

    JI was blind to the number of strata and block sizes employed within the randomisation list.

    “JI was blind to the number of strata and block sizes employed within the randomisation list.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data
    § Measures · p. 14

    The BES showed acceptable internal reliability at baseline (alpha=0.74, n=62).

    “The scale showed acceptable internal reliability at baseline (alpha=0.74, n=62).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data
    § Study design and randomisation · p. 10

    Participants in the intervention group reported starting dieting at a significantly older age than those in the control group (25 versus 20 years, p<.05).

    “However, participants in the intervention group reported starting dieting at a significantly older age than those in the control group (25 versus 20 years respectively, p&lt;.05).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning
    § Introduction · p. 7

    Cognitive defusion may help individuals refrain from bouts of overeating and adhere to exercise and eating plans.

    “Thus applied to the above cognitions it may help individuals refrain from bouts of overeating and adhere to exercise and eating plans.”
    Quote in the paperSubstantial claim
43 of 43

  • The paper relies on this without support.

    Missing data are missing at random, so that replacing missing values with the mean change from the control group is valid.

    “missing data were replaced by calculating the mean change from previous observations in the control group and adding or subtracting this figure from the previous observation relating to the missing data point.”

  • The paper relies on this without support.

    Excluding intervention participants who reported 'never' applying the workshop principles at 6 months yields a valid estimate of intervention efficacy.

    “when intervention participants who reported 'never' applying the workshop principles at 6 months (n=7) were excluded, results showed both significantly greater increases in physical activity”

  • The paper relies on this without support.

    Self-reported application of workshop principles at 6 months accurately reflects actual use.

    “the extent to which participants reported still applying the workshop principles at 6 months”

  • The paper relies on this without support.

    The present study is the first attempt to adapt mindfulness-based techniques for a programme designed exclusively for weight loss.

    “As far as we are aware the present study is the first attempt to adapt mindfulness based techniques for a programme designed exclusively for weight loss.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value: F (1, 58) = 2.31, p = .086

    Minor

    The paper reports p = .086 here; recomputing from the test statistic and its degrees of freedom gives p = .134. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .086 · recomputed p = .134

  • Inconsistent p-value: F(3, 41)=2.54, p = .054

    Minor

    The paper reports p = .054 here; recomputing from the test statistic and its degrees of freedom gives p = .070. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .054 · recomputed p = .070

2 of 2

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upF(1, 58) = 2.31reported p = .086 · recomputed p = .134

    “F (1, 58) = 2.31, p = .086”

  • Doesn’t add upF(3, 41) = 2.54reported p = .054 · recomputed p = .070

    “F(3, 41)=2.54, p = .054”

  • ConsistentF(1, 60) = 1.59reported p = .21 · recomputed p = .212

    “F(1, 60) = 1.59, p = .21”

  • ConsistentF(1, 60) = 1.29reported p = .26 · recomputed p = .261

    “F(1, 60) = 1.29, p = .26”

  • Consistentt(44) = 2.46reported p = .018 · recomputed p = .018

    “t(44)=2.46, p = .018”

  • Consistentt(45) = 1.4reported p = .17 · recomputed p = .168

    “t(45)=1.40, p = .17”

  • Consistentt(45) = 0.87reported p = .39 · recomputed p = .389

    “t(45)=0.87, p = .39”

  • Consistentt(38) = 2.24reported p = .031 · recomputed p = .031

    “t(38)=2.24, p = .031”

  • Consistentt(38) = 2.36reported p = .023 · recomputed p = .024

    “t(38)=2.36, p = .023”

9 of 9

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Self-check results appear here once an independent check has confirmed them.

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Orcutt, H. K., & Waltz, T., et al. (under review). Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological flexibility and acceptance.
  2. House of Commons Health Committee, 2004, Vol. 1

Cited by

Sorted by citations

Related

Authors
Tapper, K., Shaw, C., Ilsley, J., Hill, A. J., Bond, F. W., & Moore, L.
Affiliations
  • Swansea University (GB)
  • University of Glamorgan (GB)
  • Cardiff University (GB)
  • University of Leeds (GB)
  • University of London (GB)
Corresponding author
Tapper, Katy
ORCID
Venue
Appetite
Publisher
Elsevier BV
Published
2009-04
Volume
52
Issue
2
Pages
396-404
ISSN
0195-6663 (ISSN-L)
DOI
10.1016/j.appet.2008.11.012
OpenAlex
W2131107593
Semantic Scholar
931b1eefd6b7960d6a8e9827cb76949776128cf6
Cited by
366
References
44
Citations by year
2026: 2 · 2025: 11 · 2024: 7 · 2023: 13 · 2022: 16 · 2021: 21 · 2020: 64 · 2019: 25 · 2018: 17 · 2017: 22 · 2016: 31 · 2015: 35 · 2014: 35 · 2013: 22 · 2012: 18
FWCI
10.00
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Appetite (publishedVersion)
  • PubMed (publishedVersion)
  • City Research Online (City University London) (acceptedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
Funders
Economic and Social Research Council (ES/G007543/1)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
mindfulness-based interventions, weight loss, women, binge eating, physical activity, body mass index, mental health
MeSH terms
Adult, Awareness, Bulimia, Energy Intake, Cognition, Emotions, Feeding Behavior, Female, Humans, Mental Health, Middle Aged, Surveys and Questionnaires, Self Concept, Weight Loss, Body Mass Index, Patient Selection, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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