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Cited by 208Mindfulness and Compassion InterventionsEating Disorders and BehaviorsNutrition, Health and Food Behavior

A New Look at the Science of Weight Control: How Acceptance and Commitment Strategies Can Address the Challenge of Self-Regulation

Open access
Forman, Evan M., Butryn, Meghan L.·2015·Appetite
DOI 10.1016/j.appet.2014.10.004PMC PMC4314333
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Abstract

The current manuscript proposes an acceptance-based, self-regulation framework for understanding the challenge of weight maintenance and describes how this framework can be integrated into the behavioral treatment of obesity. According to this framework, intrinsic drives to consume palatable, high-calorie food interact with a modern environment in which high calorie foods are easily accessible. This combination produces a chronic desire to eat unhealthy foods that exists in opposition to individuals' weight control goals. Similarly, low energy expenditure requirements reduce physical activity. We suggest that individuals vary in their responsivity to cues that motivate overeating and sedentary behavior, and that those higher in responsivity need specialized self-regulatory skills to maintain healthy eating and exercise behaviors. These skills include an ability to tolerate uncomfortable internal reactions to triggers and a reduction of pleasure, behavioral commitment to clearly-defined values, and metacognitive awareness of decision-making processes. So-called "acceptance-based" interventions based on these skills have so far proven efficacious for weight control, especially for those who are the most susceptible to eating in response to internal and external cues (as predicted by the model). Despite the current empirical support for the postulated model, much remains to be learned including whether acceptance-based interventions will prove efficacious in the longer-term.

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  • CBT leads to satisfactory results with a reduction between 8 to 10% of the initial weight in childhood obesity.

    “Empirical evidence suggests that CBT leads to satisfactory results with a reduction between 8 to 10 % of the initial weight.”

    From Preliminary Results from the ACTyourCHANGE in Teens Protocol: A Randomized Controlled Trial Evaluating Acceptance and Commitment Therapy for Adolescents with Obesity (2022) · cites this paper as [9]

    In “Current Status of Obesity Problem and Obesity Interventions” (page unavailable), the paper says standard behavioral treatments commonly produce 7–10% weight reductions, supporting the general point that CBT reduces weight. It does not specify childhood obesity, and its reported range starts at 7%, not 8%. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Self-regulation skills (values, clarity, behavioral commitment, self-awareness of thoughts, feelings and bodily sensations, and distress tolerance) were found to play a protective role against the onset of unhealthy eating habits, including emotional eating.

    “Those self-regulation skills were found to play a protective role against the onset of unhealthy eating habits [9], including emotional eating.”

    From Preliminary Results from the ACTyourCHANGE in Teens Protocol: A Randomized Controlled Trial Evaluating Acceptance and Commitment Therapy for Adolescents with Obesity (2022) · cites this paper as [9]

    The Conceptual Model says that values clarity, behavioral commitment, metacognitive awareness, and distress tolerance are posited to protect against unhealthy eating decisions. The distress-tolerance section also links difficulty tolerating negative affect to emotional-eating lapses. But the paper presents the protective role as a model, not a finding that these skills prevent the onset of unhealthy eating habits. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • A theoretical model for explaining disordered eating suggests that momentary stimuli such as the availability of tasty food, a modern sedentary lifestyle, and difficult emotions can lead people to eat tasty food immediately to maintain a hedonic state of pleasure.

    “A theoretical model [20] for explaining disordered eating suggests that momentary stimuli such as the availability of tasty food in the environment, in combination with a modern sedentary lifestyle, accompanied by difficult emotions, can lead people to move toward behaviors perceived to increase or maintain a hedonic state of pleasure, such as eating tasty food immediately.”

    From The actyourchange in teens study protocol: An acceptance and commitment therapy-based intervention for adolescents with obesity: A randomized controlled trial (2021) · cites this paper as [20]

    The Conceptual Model says that food and sedentary cues, along with emotions, can prompt behavior perceived to increase or maintain a pleasurable state, including eating tasty foods. However, the paper presents this as a model of weight control, overeating, and physical-activity lapses, not specifically as a model explaining disordered eating. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Weight loss maintenance over time remains challenging.

    “However, weight loss maintenance over time remains challenging [9]”

    From Preliminary Results from the ACTyourCHANGE in Teens Protocol: A Randomized Controlled Trial Evaluating Acceptance and Commitment Therapy for Adolescents with Obesity (2022) · cites this paper as [9]

  • Forman and Butryn's self-regulation-based framework proposed that several specific self-regulation skills are needed to maintain healthy eating and physical activity.

    “To address the challenge of weight management, the theoretical model of Forman and Butryn [9] proposed a self-regulation-based framework suggesting that several specific self-regulation skills are needed to maintain healthy eating and physical activity.”

    From Preliminary Results from the ACTyourCHANGE in Teens Protocol: A Randomized Controlled Trial Evaluating Acceptance and Commitment Therapy for Adolescents with Obesity (2022) · cites this paper as [9]

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Research works printed but not linked: 1

  1. Jackson ML Williams LW Hayes SC Humphreys T Gauthier B Westwood R Whatever gets your heart pumping: Using implicit measures to select motivative exercise statements (under review)

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Authors
Forman, E. M., & Butryn, M. L.
Affiliations
Drexel University (US)
Corresponding author
Forman, Evan M.
ORCID
Venue
Appetite
Publisher
Elsevier BV
Published
2015-01
Volume
84
Pages
171-180
ISSN
0195-6663 (ISSN-L)
DOI
10.1016/j.appet.2014.10.004
PMC
PMC4314333
OpenAlex
W2088280150
Cited by
208
References
169
Citations by year
2026: 8 · 2025: 12 · 2024: 10 · 2023: 21 · 2022: 22 · 2021: 30 · 2020: 21 · 2019: 16 · 2018: 20 · 2017: 22 · 2016: 15 · 2015: 11
FWCI
2.43
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Appetite (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK092374, R01DK095069)
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
acceptance and commitment therapy, weight management, weight maintenance, obesity treatment, self-regulation, food cues, overeating, sedentary behavior, physical activity, intrinsic motivation, metacognition, behavioral commitment, long-term efficacy
MeSH terms
Adaptation, Psychological, Appetite, Attitude, Behavior Therapy, Energy Intake, Cognition, Cues, Decision Making, Diet, Eating, Environment, Feeding Behavior, Humans, Hyperphagia, Internal-External Control, Models, Psychological, Motivation, Obesity, Social Control, Informal, Health Behavior, Exercise, Pleasure, Sedentary Behavior

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