An acceptance-based behavioral intervention for weight loss: a pilot study
Open accessAbstract
On average, participants in behavioral weight-loss interventions lose 8 kilograms (kg) at 6 months, but there is marked variability in outcomes with some participants losing little or no weight. Individuals with difficulties with internal disinhibition (i.e., eating in response to emotions or thoughts) typically lose less weight in such programs and may require an innovative, specialized approach. This pilot study examined the preliminary acceptability and efficacy of a 24-week acceptance-based behavioral intervention for weight loss among overweight and obese adults reporting difficulty with eating in response to emotions and thoughts. Participants were 21 overweight or obese men and women (mean age=52.2±7.6 years; baseline mean body mass index=32.8±3.4). Eighty-six percent completed the 6-month program and a 3-month follow-up assessment. Ratings of program satisfaction averaged 4.9 on a five-point scale. Multilevel modeling analyses indicated participants lost an average of 12.0 kg (SE=1.4) after 6 months of treatment and 12.1 kg (SE=1.9) at 3-month follow-up, thus exceeding the weight losses typically seen in behavioral treatment programs. Decreases in internal disinhibition and weight-related experiential avoidance were found at 6- and 3-months follow-up. Greater decreases in weight-related experiential avoidance were associated with greater weight loss at the end of the program (r=.64, p=.002), suggesting a potential mechanism of action. Although there have been a few preliminary studies using acceptance-based approaches for obesity, this is the first study to specifically target emotional overeaters, a subgroup that might be particularly responsive to this new approach. Our findings provide initial support for the feasibility, efficacy, and acceptability of this approach for this subgroup of participants. Further study with longer follow-up, a more diverse sample, and comparison to a standard behavioral program is clearly warranted.
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Findings on weight loss after mindfulness are mixed, with some studies but not all reporting weight improvements.
“Findings on weight loss after mindfulness have been mixed, with some31–37 but not all38,39 studies reporting improvements in weight.”
From A Mindfulness-Based Intervention to Control Weight After Bariatric Surgery: Preliminary Results From a Randomized Controlled Pilot Trial (2016) · cites this paper as [37]
Initial support for the idea that acceptance-based interventions are particularly effective for these individuals comes from analog craving studies and open trial results.
“In fact, some initial support for this theoretical notion is found in the analog craving studies15–17 and open trial results20 reported above.”
From The mind your health project: a randomized controlled trial of an innovative behavioral treatment for obesity (2013) · cites this paper as [20]
In an uncontrolled trial, 21 participants with high internal disinhibition who received a 24-week acceptance-based intervention had larger-than-usual weight losses (10.2±8.2 kg) at 9-month follow-up.
“In a different, uncontrolled trial, 21 participants with high internal disinhibition received a 24-week acceptance-based intervention. Participants demonstrated larger-than-usual weight losses (10.2±8.2 kg) at a 9-month follow-up.20”
From The mind your health project: a randomized controlled trial of an innovative behavioral treatment for obesity (2013) · cites this paper as [20]
A program tailored to high internal disinhibition yielded large weight loss (12.0 kg) that was maintained at 3 months (12.1 kg).
“For example, an acceptance-based behavioral program was designed specifically for those with high internal disinhibition and displayed impressive weight loss (12.0 kg) that persisted 3 months after the intervention (12.1 kg).20”
From The mind your health project: a randomized controlled trial of an innovative behavioral treatment for obesity (2013) · cites this paper as [20]
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- Authors
- Niemeier, H. M., Leahey, T., Palm Reed, K., Brown, R. A., & Wing, R. R.
- Affiliations
- University of Wisconsin–Whitewater (US)
- Brown University (US)
- Corresponding author
- Niemeier, Heather M.
- Venue
- Behavior Therapy
- Publisher
- Elsevier BV
- Published
- 2012-06
- Volume
- 43
- Issue
- 2
- Pages
- 427-435
- ISSN
- 0005-7894 (ISSN-L)
- PMC
- PMC3535069
- OpenAlex
- W2137705110
- Cited by
- 109
- References
- 37
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 7 · 2022: 8 · 2021: 6 · 2020: 8 · 2019: 12 · 2018: 5 · 2017: 13 · 2016: 17 · 2015: 10 · 2014: 7 · 2013: 4 · 2012: 3
- FWCI
- 4.82
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Behavior Therapy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Clark Digital Commons (Clark University) (submittedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (5K23-DK73536, K23DK073536)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- weight loss, obesity, emotional overeating, experiential avoidance, overweight adults, treatment acceptability, dietary habits
- MeSH terms
- Adult, Behavior Therapy, Diet, Reducing, Female, Humans, Life Style, Male, Middle Aged, Obesity, Pilot Projects, Weight Loss, Exercise, Treatment Outcome, Patient Satisfaction, Self Efficacy, Overweight
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