Teaching Acceptance and Mindfulness to Improve the Lives of the Obese: A Preliminary Test of a Theoretical Model
Obesity is a growing epidemic. Weight control interventions can achieve weight loss, but most is regained over time. Stigma and low quality of life are significant problems that are rarely targeted.
A new model aimed at reducing avoidant behavior and increasing psychological flexibility, has shown to be relevant in the treatment of other chronic health problems and is worth examining for improving the lives of obese persons.
Patients who had completed at least 6 months of a weight loss program (N = 84) were randomly assigned to receive a 1-day, mindfulness and acceptance-based workshop targeting obesity-related stigma and psychological distress or be placed on a waiting list.
At a 3-month follow-up, workshop participants showed greater improvements in obesity-related stigma, quality of life, psychological distress, and body mass, as well as improvements in distress tolerance, and both general and weight-specific acceptance and psychological flexibility. Effects on distress, stigma, and quality of life were above and beyond the effects due to improved weight control. Mediational analyses indicated that changes in weight-specific acceptance coping and psychological flexibility mediated changes in outcomes.
Results provide preliminary support for the role of acceptance and mindfulness in improving the quality of life of obese individuals while simultaneously augmenting their weight control efforts.
KeywordsAcceptance and Commitment Therapy Experiential avoidance Stigma Coping Obesity Weight control
- 1.Center for Disease Control. Obesity and overweight. 2007; Available at http://www.cdc.gov/nccdphp/dnpa/obesity/trend/index. Accessibility verified on October 11, 2007.
- 3.Finkelstein EA, Fiebelkorn IC, Wang GJ. National medical spending attributable to overweight and obesity: How much, and who’s paying? Health Aff. 2003; 22: W219–W226.Google Scholar
- 5.Perri MG, Corisca JA. Improving the maintenance of weight loss in behavioral treatment of obesity. In: Wadden TA, Stunkard AJ, eds. Handbook of obesity treatment. New York: Guilford Press; 2002.Google Scholar
- 6.Wilson GT, Brownell KD. Behavioral treatment for obesity. In: Fairburn CG, Brownell KD, eds. Eating Disorders and Obesity. New York: Guilford Press; 2002.Google Scholar
- 19.Brownell KD, Puhl RM, Schwartz MB, Rudd L. Weight bias: Nature, consequences, remedies. New York, NY: Guilford Publications; 2005.Google Scholar
- 30.Brownell KD. The LEARN program for weight management. Dallas, TX: American Health; 2000.Google Scholar
- 31.Hayes SC, Strosahl K, Wilson KG. Acceptance and Commitment Therapy: An experiential approach to behavior change. New York, NY: The Guilford Press; 1999.Google Scholar
- 36.Luoma JB, Kohlenberg BS, Hayes SC, Bunting K, Rye AK. Reducing the self stigma of substance abuse through acceptance and commitment therapy: Model, manual development, and pilot outcomes. Addiction Res Ther. In press.Google Scholar
- 38.Masuda A, Hayes SC, Fletcher LB, et al. The impact of Acceptance and Commitment Therapy versus education on stigma toward people with psychological disorders. Beh Res Ther. In press.Google Scholar
- 42.Brown RA, Palm KM, Strong DR, et al. Distress tolerance treatment for early lapse smokers: Rationale, program description and preliminary findings. Behav Modif. In press.Google Scholar
- 43.Hayes SC. Smith S. Get out of your mind and into your life: The new Acceptance and Commitment Therapy. Oakland, CA: New Harbinger; 2005.Google Scholar
- 44.Goldberg DP. The detection of psychiatric illness by questionnaire. London: Oxford University Press; 1972.Google Scholar
- 47.Lillis J. Acceptance and Commitment Therapy for the treatment of obesity-related stigma and weight control. Unpublished doctoral dissertation, University of Nevada, Reno; 2007.Google Scholar
- 48.Rosenberg M. Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press; 1965.Google Scholar
- 51.Allison DB, Basile VC, Yuker HE. The measurement of attitudes and beliefs about obese persons. Int J Eat Disord. 1991; 10: 599–607.Google Scholar
- 53.Hayes SC, Strosahl KD, Wilson KG, et al. Measuring experiential avoidance: A preliminary test of a working model. Psychol Rec. 2004; 54: 553–578.Google Scholar
- 54.Lillis J, Hayes SC. Measuring avoidance and inflexibility in weight related problems. Int J Behav Consult Ther. 2008; 4: 30–40.Google Scholar
- 60.Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. In: Leinhardt S. ed. Sociological Methodlogy. Washington, DC: American Sociological Association; 1982.Google Scholar
- 61.Preacher KJ, Hayes AF. SPSS and SAS Procedures for estimating effects in simple mediation models. Behav Res Meth Instrum Comput. 2004; 36: 717–731.Google Scholar
- 62.Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. In press.Google Scholar