A Randomized Trial of an Acceptance-Based Behavioral Intervention for Weight Loss in People with High Internal Disinhibition

Objective: To determine whether an acceptance-based behavioral intervention (ABBI) produces better weight losses than standard behavioral treatment (SBT) among individuals reporting high internal disinhibition. Methods: Participants were 162 adults with overweight or obesity (mean BMI 37.6 kg/m(2)) randomly assigned to ABBI or SBT. Both interventions provided the same calorie intake target, exercise goal, and self-monitoring skills training. SBT incorporated current best practice interventions for addressing problematic thoughts and emotions. ABBI utilized acceptance-based techniques based on Acceptance and Commitment Therapy. ABBI and SBT were compared on weight change and internal disinhibition change over 24 months. Results: Mixed models analysis showed mean weight loss at 24 months was -4.1% (SE = 0.88) for ABBI and -2.4% (SE = 0.87) for SBT (P = 0.204). Secondary analyses showed that the ABBI group regained less weight from the end of treatment to the final follow-up (4.6 vs. 7.1 kg; P = 0.005), and that a significantly higher proportion of ABBI participants achieved a 5% weight loss (38% vs. 25%; P = 0.038) at 24 months. Conclusions: Results suggest that ABBI could be helpful for improving the maintenance of weight loss for individuals who report high internal disinhibition.