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A pilot study of acceptance-based behavioural weight loss for adolescents with obesity

Published online by Cambridge University Press:  17 April 2019

Jena Shaw Tronieri*
Affiliation:
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
Thomas A. Wadden
Affiliation:
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
Sharon M. Leonard
Affiliation:
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
Robert I. Berkowitz
Affiliation:
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
*
*Corresponding author. Email: jena.tronieri@pennmedicine.upenn.edu

Abstract

Background:

Acceptance and commitment therapy (ACT) is a psychological treatment that has been found to increase weight loss in adults when combined with lifestyle modification, compared with the latter treatment alone. However, an ACT-based treatment for weight loss has never been tested in adolescents.

Methods:

The present pilot study assessed the feasibility and acceptability of a 16-week, group ACT-based lifestyle modification treatment for adolescents and their parents/guardians. The co-primary outcomes were: (1) mean acceptability scores from up to 8 biweekly ratings; and (2) the percentage reduction in body mass index (BMI) from baseline to week 16. The effect size for changes in cardiometabolic and psychosocial outcomes from baseline to week 16 also was examined.

Results:

Seven families enrolled and six completed treatment (14.3% attrition). The mean acceptability score was 8.8 for adolescents and 9.0 for parents (on a 1–10 scale), indicating high acceptability. The six adolescents who completed treatment experienced a 1.3% reduction in BMI (SD = 2.3, d = 0.54). They reported a medium increase in cognitive restraint, a small reduction in hunger, and a small increase in physical activity. They experienced small improvements in most quality of life domains and a large reduction in depression.

Conclusions:

These preliminary findings indicate that ACT plus lifestyle modification was a highly acceptable treatment that improved weight, cognitive restraint, hunger, physical activity, and psychosocial outcomes in adolescents with obesity.

Type
Main
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

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References

Abrams, P., Levitt Katz, L. E., Moore, R. H., Xanthopoulos, M. S., Bishop-Gilyard, C. T., Wadden, T. A. and Berkowitz, R. I. (2013). Threshold for improvement in insulin sensitivity with adolescent weight loss. Journal of Pediatrics, 163, 785790. doi: 10.1016/j.jpeds.2013.04.003 CrossRefGoogle ScholarPubMed
Beck, A. T., Steer, R. A. and Brown, G. K. (1996). Beck Depression Inventory-II (BDI-II) Manual. San Antonio, TX: Harcourt Brace.Google Scholar
Beck, A. T., Steer, R. A. and Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review, 8, 77100.CrossRefGoogle Scholar
Berkowitz, R. I., Rukstalis, M. R., Bishop-Gilyard, C. T., Moore, R. H., Gehrman, C. A., Xanthopoulos, M. S., … Wadden, T. A. (2013). Treatment of adolescent obesity comparing self-guided and group lifestyle modification programs: a potential model for primary care. Journal of Pediatric Psychology, 38, 978986. doi: 10.1093/jpspsy/jst035 CrossRefGoogle ScholarPubMed
Berkowitz, R. I., Wadden, T. A., Gehrman, C. A., Bishop-Gilyard, C. T., Moore, R. H., Womble, L. G., … Xanthopoulos, M. S. (2011). Meal replacements in the treatment of adolescent obesity: a randomized controlled trial. Obesity, 19, 1193–99. doi: 10.1038/oby.2010.288 CrossRefGoogle ScholarPubMed
Cardaciotto, L., Herbert, J. D., Forman, E. M., Moitra, E. and Farrow, V. (2008). The assessment of present-moment awareness and acceptance: the Philadelphia Mindfulness Scale. Assessment, 15, 204223. doi: 10.1177/1073191107311467 CrossRefGoogle ScholarPubMed
Cheron, D. M., Ehrenreich, J. T. and Pincus, D. B. (2009). Assessment of parental experiential avoidance in a clinical sample of children with anxiety disorders. Child Psychiatry and Human Development, 40, 383403. doi: 10.1007/s10578-009-0135-z CrossRefGoogle Scholar
Cohen, S., Kamarck, T. and Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385396. doi: 10.2307/2136404 CrossRefGoogle ScholarPubMed
Coyne, L. W., McHugh, L. and Martinez, E. R. (2011). Acceptance and commitment therapy (ACT): advances and applications with children, adolescents, and families. Child and Adolescent Psychiatric Clinics of North America, 20, 379399. doi: 10.1016/j.chc.2011.01.010 CrossRefGoogle ScholarPubMed
Economos, C. D., Hyatt, R. R., Must, A., Goldberg, J. P., Kuder, J., Naumova, E. N., … Nelson, M. E. (2013). Shape Up Somerville two-year results: a community-based environmental change intervention sustains weight reduction in children. Preventive Medicine, 57, 322327. doi: 10.1016/j.ypmed.2013.06.001 CrossRefGoogle ScholarPubMed
Forman, E., Butryn, M., Juarascio, A., Bradley, L., Lowe, M., Herbert, J. and Shaw, J. (2013). The Mind Your Health project: a randomized controlled trial of an innovative behavioral treatment for obesity. Obesity, 21, 11191126. doi: 10.1002/oby.20169 CrossRefGoogle ScholarPubMed
Forman, E. M., Butryn, M. L., Manasse, S. M., Crosby, R. D., Goldstein, S. P., Wyckoff, E. P. and Thomas, J. G. (2016). Acceptance-based versus standard behavioral treatment for obesity: results from the mind your health randomized controlled trial. Obesity, 24, 20502056. doi: 10.1002/oby.21601 CrossRefGoogle ScholarPubMed
Franckle, R., Adler, R. and Davison, K. (2014). Accelerated weight gain among children during summer versus school year and related racial/ethnic disparities: a systematic review. Preventing Chronic Disease, 11, E101. doi: 10.5888/pcd11.130355 CrossRefGoogle ScholarPubMed
Garner, D. (1991). Eating Disorder Inventory-2: Professional Manual. Florida: Psychological Assessment Resources.Google Scholar
Greco, L. A., Baer, R. A. and Smith, G. T. (2011). Assessing mindfulness in children and adolescents: development and validation of the Child and Adolescent Mindfulness Measure (CAMM). Psychological Assessment, 23, 606614. doi: 10.1037/a0022819 CrossRefGoogle Scholar
Greco, L. A., Lambert, W. and Baer, R. A. (2008). Psychological inflexibility in childhood and adolescence: development and evaluation of the Avoidance and Fusion Questionnaire for Youth. Psychological Assessment, 20, 93102. doi: 10.1037/1040-3590.20.2.93 CrossRefGoogle ScholarPubMed
Halliburton, A. E. and Cooper, L. D. (2015). Applications and adaptations of Acceptance and Commitment Therapy (ACT) for adolescents. Journal of Contextual Behavioral Science, 4, 111. doi: 10.1016/j.jcbs.2015.01.002 CrossRefGoogle Scholar
Hayes, S. C., Strosahl, K. D. and Wilson, K. G. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York, NY, USA: Guilford Press.Google Scholar
Johnson, J. G., Harris, E. S., Spitzer, R. L. and Williams, J. B. W. (2002). The patient health questionnaire for adolescents: validation of an instrument for the assessment of mental disorders among adolescent primary care patients. Journal of Adolescent Health, 30, 196204. doi: 10.1016/S1054-139X(01)00333-0 CrossRefGoogle ScholarPubMed
Kelley, J. C., Stettler-Davis, N., Leonard, M. B., Hill, D., Wrotniak, B. H., Shults, J., … Zemel, B. S. (2018). Effects of a randomized weight loss intervention trial in obese adolescents on tibia and radius bone geometry and volumetric density. Journal of Bone and Mineral Research, 33, 4253. doi: 10.1002/jbmr.3288 CrossRefGoogle ScholarPubMed
Kolotkin, R. L., Zeller, M., Modi, A. C., Samsa, G. P., Quinlan, N. P., Yanovski, J. A., … Roehrig, H. R. (2006). Assessing weight-related quality of life in adolescents. Obesity, 14, 448457. doi: 10.1038/oby.2006.59 CrossRefGoogle ScholarPubMed
Kowalski, K. C., Crocker, P. R. E. and Kowalski, N. P. (1997). Convergent validity of the physical activity questionnaire for adolescents. Pediatric Exercise Science, 9, 342352.CrossRefGoogle Scholar
Moyer, D. N. and Sandoz, E. K. (2015). The role of psychological flexibility in the relationship between parent and adolescent distress. Journal of Family Studies, 24, 14061418. doi: 10.1007/s10826-014-9947-y CrossRefGoogle Scholar
Newton, J. T. and Sturmey, P. (2004). Development of a short form of the treatment evaluation inventory for acceptability of psychological interventions. Psychological Reports, 94, 475481. doi: 10.2466/pr0.94.2.475-481 CrossRefGoogle Scholar
Oude Luttikhuis, H., Baur, L., Jansen, H., Shrewsbury, V. A., O’Malley, C., Stolk, R. P., and Summerbell, C. D. (2009). Cochrane Review: Interventions for treating obesity in children. Evidence-based Child Health: A Cochrane Review Journal, 4, 15711729.CrossRefGoogle Scholar
Steinberg, L. (2010). A behavioral scientist looks at the science of adolescent brain development. Brain and Cognition, 72, 160164.CrossRefGoogle ScholarPubMed
Stunkard, A. J. and Messick, S. (1988). Eating Inventory Manual. New York: Psychological Corporation.Google Scholar
The, N. S., Suchindran, C., North, K. E., Popkin, B. M. and Gordon-Larsen, P. (2010). Association of adolescent obesity with risk of severe obesity in adulthood. JAMA, 304, 20422047. doi: 10.1001/jama.2010.1635 CrossRefGoogle ScholarPubMed
Thomason, D. L., Lukkahatai, N., Kawi, J., Connelly, K. and Inouye, J. (2016). A systematic review of adolescent self-management and weight loss. Journal of Pediatric Health Care, 30, 569582. doi: 10.1016/j.pedhc.2015.11.016 CrossRefGoogle ScholarPubMed
Wadden, T. A., Berkowitz, R. I., Womble, L. G., Sarwer, D. B., Phelan, S., Cato, R. K., … Stunkard, A. J. (2005). Randomized trial of lifestyle modification and pharmacotherapy for obesity. The New England Journal of Medicine, 353, 21112120. doi: 10.1056/NEJMoa050156 CrossRefGoogle ScholarPubMed
Ware, J. E. Jr and Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473483.CrossRefGoogle ScholarPubMed
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