ACTonFood. Acceptance and Commitment Therapy-Based Group Treatment Compared to Cognitive Behavioral Therapy-Based Group Treatment for Weight Loss Maintenance: An Individually Randomized Group Treatment Trial

Roberto Cattivelli,Giada Pietrabissa,Anna Guerrini Usubini,Christian Franceschini,Emanuele Giusti,Chiara A M Spatola,Alessandro Musetti,Gianluca Castelnuovo,Enrico Molinari,Francesco Vailati Riboni,Gian Mauro Manzoni,Giorgia Varallo

doi:10.3390/ijerph18189558

Abstract

The purpose of this Individually Randomized Group Treatment Trial was to compare an Acceptance and Commitment Therapy-based (ACT) group intervention and a Cognitive Behavioral Therapy-based (CBT) group intervention for weight loss maintenance in a sample of adult patients with obesity seeking treatment for weight loss. One hundred and fifty-five adults (BMI: Kg/m2 = 43.8 [6.8]) attending a multidisciplinary rehabilitation program for weight loss were randomized into two conditions: ACT and CBT. Demographical, physical, and clinical data were assessed at the beginning of the program (t0), at discharge (t1), and at 6-month follow-up (t2). The following measures were administered: The Acceptance and Action Questionnaire-II (AAQ-II) and the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). Generalized linear mixed models were performed to assess differences between groups. Moderation effects for gender and Eating Disorders (ED) have been considered. From baseline to discharge, no significant differences between interventions were found, with the only exception of an improvement in the CORE-OM total score and in the CORE-OM subjective wellbeing subscale for those in the CBT condition. From discharge to follow-up, ACT group participants showed significant results in terms of weight loss maintenance, CORE-OM total score, and CORE-OM and AAQ-II wellbeing, symptoms, and psychological problems subscales. Gender moderated the effects of time and intervention on the CORE-OM subscale reporting the risk for self-harm or harm of others. The presence of an eating disorder moderated the effect of time and intervention on the CORE-OM total score, on the CORE-OM symptoms and psychological problems subscales, and on the AAQ-II. Patients who received the ACT intervention were more likely to achieve a ≥5% weight loss from baseline to follow-up and to maintain the weight loss after discharge. The ACT intervention was thus effective in maintaining weight loss over time.

Highlights

IntroductionObesity can be considered as one of the most dominant public-health challenges of the
Obesity can be considered as one of the most dominant public-health challenges of the21st century [1,2,3,4,5,6]
The present study aimed to evaluate the efficacy of a newly developed ACT-based group intervention improving weight-loss maintenance compared with a standard Cognitive Behavioral Therapy-based (CBT)-based group treatment in a sample of Italian participants with obesity involved in a multidisciplinary in-hospital rehabilitation program for weight reduction

Summary

Introduction

Obesity can be considered as one of the most dominant public-health challenges of the. 21st century [1,2,3,4,5,6]. Recent estimates have pointed out how over the last decades obesity has. Root metaphor—Passenger in the Bus. Values and obstacles to value-based actions

Results

Discussion

Conclusion