Acceptance-and mindfulness-based interventions for health behavior change: Systematic reviews and meta-analyses
Open accessAbstract
Behavioral health issues such as smoking and overweight are risk factors for a variety of adverse health outcomes, including mortality. Over the past decade, a growing number of randomized controlled trials have examined the efficacy of acceptance- and mindfulness-based interventions for smoking cessation and weight loss. The purpose of the current meta-analytic reviews was to quantitatively synthesize the existing literature comparing these interventions to controls for a) smoking cessation and b) weight loss outcomes. Searches identified 17 smoking cessation studies and 31 weight loss studies eligible for inclusion. Meta-analytic results indicated a non-significant effect favoring acceptance- and mindfulness-based interventions over controls for smoking cessation (OR = 1.13) and a small, significant effect favoring these interventions over controls for weight loss outcomes (Hedge's g = 0.30). Statistical heterogeneity and risk of bias were assessed. Subgroup and meta-regression analyses were conducted to examine moderating variables (e.g., sample and intervention characteristics). The findings indicated that acceptance- and mindfulness-based interventions were at least as efficacious as active control conditions. Given the significant health risks associated with smoking and overweight, these findings have important clinical and public health implications. Limitations (e.g., relative infancy of the literature; lack of diversity in sample demographics) and future directions (e.g., further exploration of mediators and moderators of change) are discussed.
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Existing reviews with a focus on mindfulness often include acceptance-based interventions.
“Existing reviews with a focus on mindfulness often include acceptancebased interventions. 3-14”
From Randomized Controlled Trials of Mindfulness and Acceptance-Based Interventions Over the Past Two Decades: A Bibliometric Analysis. (2021) · cites this paper as [11]
The 'Previous weight loss reviews' section describes meta-analyses that included both mindfulness- and acceptance-based interventions, supporting the claim that some existing reviews combine them. It also identifies a mindfulness-only meta-analysis, so this paper does not establish that mindfulness-focused reviews *often* include acceptance-based interventions. No page numbers are available in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measuredIn Roche et al.'s review, there were not significant effects for smoking cessation, and a significant but slight effect for weight loss.
“In Roche, Kroska, and Denburg’s review [16], there were not significant effects for smoking cessation (and a significant but slight effect for weight loss).”
From The effectiveness of mindfulness-based interventions on anxiety disorders. A systematic meta-review (2020) · cites this paper as [16]
A small but significant difference in weight or BMI was reported at post-intervention, favouring mindfulness and acceptance-based interventions over comparator arms.
“A small but significant difference in weight or BMI was reported at post‐intervention, favouring mindfulness and acceptance‐based interventions over comparator arms.”
From Third‐wave cognitive behaviour therapies for weight management: A systematic review and network meta‐analysis (2020) · cites this paper as [14]
Subgroup analysis suggested that the effect may only hold when the comparator is waitlist control.
“Subgroup analysis suggested that the effect may only hold when the comparator is waitlist control.”
From Third‐wave cognitive behaviour therapies for weight management: A systematic review and network meta‐analysis (2020) · cites this paper as [14]
Only one review reported a meta-analytic synthesis that compared the effectiveness of mindfulness- and acceptance-based interventions with those in other active interventions and control arms using appropriate statistical methods.
“Critically, only one review14 reported a meta‐analytic synthesis that compared the effectiveness of mindfulness‐ and acceptance‐based interventions with those in other active interventions and control arms using appropriate statistical methods.”
From Third‐wave cognitive behaviour therapies for weight management: A systematic review and network meta‐analysis (2020) · cites this paper as [14]
In that review, there was no restriction on the minimum follow-up duration and outcomes were analysed at 1-month post-intervention (or the closest measurement to this).
“In that review, there was no restriction on the minimum follow‐up duration and outcomes were analysed at 1‐month post‐intervention (or the closest measurement to this).”
From Third‐wave cognitive behaviour therapies for weight management: A systematic review and network meta‐analysis (2020) · cites this paper as [14]
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Lillis, J., Niemeier, H. M., Thomas, J. G., Unick, J. L., Ross, K. M., Leahey, T. M., Kendra, K. E., Dorfman, L. R., & Wing, R. R. (2016) · Obesity · doi:10.1002/oby.21680 · Cited by 74 · see citing works
Mindfulness-Based Interventions for the Treatment of Smoking: A Systematic Literature Review
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Butryn, M. L., Forman, E. M., Lowe, M. R., Gorin, A. A., Zhang, F., & Schaumberg, K. (2017) · Obesity · doi:10.1002/oby.21813 · Cited by 57 · see citing works
Corsica, J. A., Hood, M. M., Katterman, S. N., Kleinman, B. M., & Ivan, I. I. (2014) · Eating Behaviors · doi:10.1016/j.eatbeh.2014.08.002 · Cited by 55 · see citing works
O’Connor, M., Whelan, R., Bricker, J., & McHugh, L. (2020) · Behavior Therapy · doi:10.1016/j.beth.2019.06.003 · Cited by 55 · see citing works
Mindfulness‐Based Stress Reduction in Women with Overweight or Obesity: A Randomized Clinical Trial
Raja‐Khan, N., Agito, K., Shah, J., Stetter, C. M., Gustafson, T. S., Socolow, H., Kunselman, A. R., Reibel, D. K., & Legro, R. S. (2017) · Obesity · doi:10.1002/oby.21910 · Cited by 53 · see citing works
McClure, J. B., Bricker, J. B., Mull, K. E., & Heffner, J. L. (2018) · Nicotine & Tobacco Research · doi:10.1093/ntr/nty268 · Cited by 52 · see citing works
Lappalainen, R. I., Sairanen, E., Järvelä‐Reijonen, E., Rantala, S., Korpela, R., Puttonen, S., Kujala, U. M., Myllymäki, T., Peuhkuri, K., Mattila, E., et al. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-310 · Cited by 47 · see citing works
Spadaro, K. C., Davis, K. K., Sereika, S. M., Gibbs, B. B., Jakicic, J. M., & Cohen, S. M. (2018) · Journal of Complementary and Integrative Medicine · doi:10.1515/jcim-2016-0048 · Cited by 47 · see citing works
Sairanen, E., Tolvanen, A., Karhunen, L., Kolehmainen, M., Järvelä-Reijonen, E., Lindroos, S., Peuhkuri, K., Korpela, R., Ermes, M., Mattila, E., et al. (2017) · Public Health Nutrition · doi:10.1017/s1368980017000441 · Cited by 44 · see citing works
Developing and validating the “composite measure of problem behaviors”
Kingston, J. L., Clarke, S., Ritchie, T. D., & Remington, B. (2011) · Journal of Clinical Psychology · doi:10.1002/jclp.20802 · Cited by 39 · see citing works
Avoidance and inflexibility as a common clinical pathway in obesity and smoking treatment
Gifford, E. V., & Lillis, J. (2009) · Journal of Health Psychology · doi:10.1177/1359105309342304 · Cited by 39 · see citing works
Smith, B. W., Shelley, B. M., Sloan, A. L., Colleran, K., & Erickson, K. (2018) · Mindfulness · doi:10.1007/s12671-017-0824-9 · Cited by 37 · see citing works
Nonpharmacologic Therapy for Smoking Cessation: Characteristics and Efficacy of Current Approaches
NIAURA, R. S. (2008) · The American Journal of Medicine · doi:10.1016/j.amjmed.2008.01.021 · Cited by 34 · see citing works
A Randomized Pilot Study of a Phone-Based Mindfulness and Weight Loss Program
Carpenter, K., Vickerman, K. A., Salmon, E. E., Javitz, H. S., Epel, E. S., & Lovejoy, J. C. (2017) · Behavioral Medicine · doi:10.1080/08964289.2017.1384359 · Cited by 33 · see citing works
A randomized controlled trial of distress tolerance treatment for smoking cessation.
Brown, R. A., Reed, K. M. P., Bloom, E. L., Minami, H., Strong, D. R., Lejuez, C. W., Zvolensky, M. J., & Hayes, S. C. (2018) · Psychology of Addictive Behaviors · doi:10.1037/adb0000372 · Cited by 32 · see citing works
Measuring Experiential Avoidance: Evidence toward Multidimensional Predictors of Trauma Sequelae
Lewis, M., & Naugle, A. (2017) · Behavioral Sciences · doi:10.3390/bs7010009 · Cited by 20 · see citing works
Martin, L., Espel‐Huynh, H., Marando-Blanck, S., Evans, B. C., Forman, E. M., Butryn, M. L., Baer, R. A., Wolever, R. Q., & Herbert, J. D. (2017) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2017.09.002 · Cited by 16 · see citing works
Fletcher, L. B. (2011) · ProQuest Demo Repository · Cited by 11 · see citing works
Blevins, N. C. (2008) · Cited by 8 · see citing works
The “Midlife Study" mindfulness as an intervention to change health behaviors in midlife women.
Frisvold, M. H. (2009) · University of Minnesota Digital Conservancy (University of Minnesota) · Cited by 4 · see citing works
WEIGHT LOSS: EXPLORING SELF-REGULATION THROUGH MINDFULNESS MEDITATION
Spadaro, K. C. (2008) · D-Scholarship@Pitt (University of Pittsburgh) · Cited by 3 · see citing works
Potts, S. (2021) · Digital Commons - USU (Utah State University) · doi:10.26076/0085-9c74 · Cited by 2 · see citing works
Richards, S. M. (2021) · Digital Commons - USU (Utah State University) · doi:10.26076/b0d7-1b15 · Cited by 1 · see citing works
Flagged first, then by citations
1 of the 123 references couldn’t be matched to a known paper.
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- Baer RA (Ed.). (2015). Mindfulness-based treatment approaches: Clinician’s guide to evidence base and applications. Elsevier.
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Mindfulness and Behavior Change
Schuman-Olivier, Z., Trombka, M., Lovas, D. A., Brewer, J. A., Vago, D. R., Gawande, R., Dunne, J. P., Lazar, S. W., Loucks, E. B., & Fulwiler, C. (2020) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000277 · Cited by 435 · see citing works
Mindful eating: what we know so far
Tapper, K. (2022) · Nutrition Bulletin · doi:10.1111/nbu.12559 · Cited by 118 · see citing works
Lawlor, E. R., Islam, N., Bates, S., Griffin, S. J., Hill, A. J., Hughes, C. A., Sharp, S. J., & Ahern, A. L. (2020) · Obesity Reviews · doi:10.1111/obr.13013 · Cited by 103 · see citing works
The effectiveness of mindfulness-based interventions on anxiety disorders. A systematic meta-review
Fumero, A., Peñate, W., Oyanadel, C., & Porter, B. (2020) · European Journal of Investigation in Health, Psychology and Education · doi:10.3390/ejihpe10030052 · Cited by 64 · see citing works
“In Roche, Kroska, and Denburg’s review [16], there were not significant effects for smoking cessation (and a significant but slight effect for weight loss).”
BackgroundIturbe, I., Echeburúa, E., & Maíz, E. (2021) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2695 · Cited by 48 · see citing works
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Behavioral Science and Education for Sustainable Development: Towards Metacognitive Competency
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Ma, Y., Kraemer, K. M., Lyu, J., & Yeh, G. Y. (2021) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2020.0548 · Cited by 22 · see citing works
A 1-day acceptance and commitment therapy workshop leads to reductions in emotional eating in adults
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Non-pharmaceutical interventions to optimize cancer immunotherapy
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Acceptance: A Research Overview and Application of This Core ACT Process in ABA
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Chew, H. S. J., Achananuparp, P., Dalakoti, M., Chew, N., Chin, Y. H., Gao, Y., So, J. B. Y., Shabbir, A., Peng, L. E., & Ngiam, K. Y. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1287156 · Cited by 8 · see citing works
Dispositional mindfulness and its relationship to exercise motivation and experience
Lynn, S., Satyal, M. K., Smith, A. J., Tasnim, N., Gyamfi, D., English, D. F., SUZUKI, W. A., & Basso, J. C. (2022) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2022.934657 · Cited by 7 · see citing works
Cox, J. S., Iturbe, I., Searle, A., Maíz, E., & Hinton, E. C. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.11.004 · Cited by 7 · see citing works
Mittal, T. K., Evans, E., Pottle, A., Lambropoulos, C., Morris, C., Surawy, C., Chuter, A., Cox, F., de Silva, R., Mason, M. J., et al. (2022) · Open Heart · doi:10.1136/openhrt-2022-001970 · Cited by 7 · see citing works
Franco, C., Ayala, E. S., Amutio, A., & Mañas, I. M. (2020) · Terapia psicológica · doi:10.4067/s0718-48082020000100005 · Cited by 6 · see citing works
Matovic, D., Ahern, M., Sherman, K. A., Johnco, C. J., Willcock, S., & Wuthrich, V. M. (2023) · Australian Psychologist · doi:10.1080/00050067.2023.2267158 · Cited by 5 · see citing works
Iturbe, I., Urkia-Susín, I., Echeburúa, E., Barbón, A. M., & Maíz, E. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100827 · Cited by 5 · see citing works
Wippold, G. M., & Frary, S. G. (2021) · The Journal of prevention · doi:10.1007/s10935-021-00652-1 · Cited by 4 · see citing works
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The Next Steps in Reducing Risk for Dementia
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Effectiveness of a Smoking Cessation Program during the COVID-19 Pandemic
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Verhaltensmedizinische Kardiologie
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Obesity: Third Wave Case Conceptualization
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Bedside Cognitive Behavioral Therapy Techniques in Primary Care
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The Relationship Between Death Anxiety and Health Behaviors in Patients With Heart Failure
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- Authors
- Roche, A. I., Kroska, E. B., & Denburg, N. L.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Roche, Anne I.
- Venue
- Journal of Contextual Behavioral Science
- Publisher
- Elsevier BV
- Published
- 2019-07
- Volume
- 13
- Pages
- 74-93
- ISSN
- 2212-1447 (ISSN-L)
- PMC
- PMC7442228
- OpenAlex
- W2951504778
- Cited by
- 41
- References
- 123
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 8 · 2023: 8 · 2022: 5 · 2021: 7 · 2020: 6 · 2019: 1
- FWCI
- 0.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Contextual Behavioral Science (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- acceptance and commitment therapy, mindfulness-based interventions, smoking cessation, weight loss, health behavior change, overweight, active control, treatment efficacy
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