Acceptance-based therapy may help adolescents with obesity to lose weight
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Acceptance-based therapy was as effective as enhanced care for weight loss among adolescent girls with overweight or obesity, according to a pilot randomized controlled trial published in Childhood Obesity.
“Acceptance-based therapy teaches self-regulatory skills, assisting patients in accepting uncomfortable internal states that may discourage participation in activities that align with their goals. ... Acceptance-based interventions have been used to treat chronic pain, risky sexual behavior, anorexia and mental well-being among adolescents,” Faith A. Newsome, BA, graduate research assistant and PhD student in the department of health outcomes and biomedical informatics at the University of Florida College of Medicine, and colleagues wrote. “Acceptance-based therapy is a particularly relevant intervention for obesity as it focuses on self-regulatory skills, and teens with obesity exhibit worse self-regulatory skills compared with teens without obesity.”
This 6-month, two-arm, pilot study included 40 adolescent girls (mean age, 15.8 years) with overweight or obesity aged 14 to 19 years. All participants were randomly assigned to the Wellness Achieved Through Changing Habits intervention, an acceptance-based therapy, (n = 20) or enhanced care (n = 20). Participants who received the acceptance-based therapy intervention attended 15 virtual, 90-minute group sessions during the study period. Participants who received enhanced care received 15 healthy lifestyle handouts and met twice virtually with a registered dietitian.
The primary outcome was BMI change expressed by percentage of the 95th percentile.
Researchers observed a decrease in BMI percentage among participants in the acceptance-based therapy intervention group (mean change = –1.11; 95% CI, –4.69 to 2.48), but not among participants in the enhanced care group (mean change = –0.08; 95% CI, –4.54 to 4.38). In addition, participants in the enhanced care group gained weight from baseline to 6 months, whereas participants in the acceptance-based therapy intervention group did not.
Participants in the acceptance-based therapy intervention group experienced slight changes in psychological flexibility (mean change = –0.34; 95% CI, –0.62 to –0.06) compared with participants in the enhanced care group (mean change = –0.11; 95% CI, –0.58 to 0.37).
In additional analyses conducted with two, sequentially run cohorts in fall 2020 and spring 2021, researchers observed a mean weight change of –0.96 kg in the acceptance-based group in fall 2020 compared with a mean weight change of 2.93 kg in the acceptance-based group in spring 2021. Mean weight change in the enhanced care group in fall 2020 was 0.66 kg and 0.87 kg in spring 2021.
Researchers observed no significant intervention effect between the acceptance-based therapy intervention group and the enhanced care group.
“Future research should investigate in-person delivery of an acceptance-based therapy intervention for adolescents, and best practices for optimizing virtual interventions,” the researchers wrote.
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