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Journal article
An individual participant data meta-analysis investigating the mediating role of eating behavior traits in Acceptance and Commitment Therapy-based weight management interventions
Annals of behavioral medicine, v 59(1), kaaf039
02 Jun 2025
PMID: 40451242
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Identifying mechanisms of action can aid the refinement of weight management interventions. Acceptance and Commitment Therapy (ACT)-based interventions may support long-term weight management by improving self-regulation of eating behavior traits (EBTs). However, it remains unclear if changing EBTs like emotional eating, external eating, internal disinhibition, and restraint during ACT causes improved weight management.
For this 1-stage Individual Participant Data (IPD) meta-analysis, we requested IPD from 9 trials identified through a systematic search of ACT-based interventions for adults with a body mass index >25 kg/m2 across 8 databases until June 20, 2022. We obtained, checked, and harmonized data from 8 of those trials (N = 1391) and conducted separate structural equation models with complex survey analysis to estimate short- and long-term mediating effects of changes in each EBT on percent weight change.
In the short-term (ie, follow-up closest to intervention end), we found indirect effects of the intervention on percent weight change through changes in emotional eating, external eating, internal disinhibition, and restraint. Each 1-unit change in these EBTs led to a 0.02% (95% CI, 0.05-0.001), 0.03% (95% CI, 0.06-0.001), 0.05% (95% CI, 0.11-0.02), and 0.09% (95% CI, 0.14-0.04) decrease in weight, respectively. In the long term (ie, 12 months after intervention end), we found both indirect and total effects for emotional eating, internal disinhibition, and restraint, with EBT changes explaining 23.78%, 23.12%, and 25.64% of total effects.
Findings suggest small partial mediating effects of ACT on weight through EBTs. Targeting EBTs may support improved weight management outcomes, particularly in the long term.
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Details
- Title
- An individual participant data meta-analysis investigating the mediating role of eating behavior traits in Acceptance and Commitment Therapy-based weight management interventions
- Creators
- Laura Kudlek (Corresponding Author) - MRC Epidemiology UnitJulia Mueller - MRC Epidemiology UnitPatricia Eustachio Colombo - University of CambridgeStephen J Sharp - University of CambridgeClare E Boothby - MRC Epidemiology UnitSimon J Griffin - MRC Epidemiology UnitMeghan Butryn - Drexel UniversityChristina Chwyl - Drexel UniversityEvan Forman - Drexel UniversityCharlotte Hagerman - Drexel UniversityMisty Hawkins - Indiana University BloomingtonAdrienne Juarascio - Drexel UniversityBärbel Knäuper - McGill UniversityMarjukka Kolehmainen - University of Eastern FinlandMichael E Levin - Utah State UniversityJason Lillis - Brown UniversityEdurne Maiz - University of the Basque CountryStephanie Manasse - Drexel UniversityLara Palmeira - Universidade PortucalenseKirsi H Pietiläinen - University of HelsinkiNancy E Sherwood - University of MinnesotaAmy Ahern - MRC Epidemiology Unit
- Publication Details
- Annals of behavioral medicine, v 59(1), kaaf039
- Publisher
- Oxford University Press
- Number of pages
- 12
- Grant note
- Cambridge Biomedical Research Centre NIHR203312 / National Institute for Health and Care Research MC_UU_00006/6 / Medical Research Council
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); WELL Center
- Web of Science ID
- WOS:001504325100001
- Scopus ID
- 2-s2.0-105007176920
- Other Identifier
- 991022054481404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Psychology, Multidisciplinary