Commentary for Special Issue on Using Baseline Target Moderation to Assess Variation in Prevention Impact: When (and How) to Revise Our Programs

Journal article

Abstract Background 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. Methods 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. Results 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. Conclusion 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.

Authors: Gardner, F

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Prevention Science
• Volume: 24
• Issue: 2
• Pages: 299-303
• Publication date: 2022-11-23
• DOI: 10.1007/s11121-022-01458-1
• EISSN: 1573-6695
• ISSN: 1389-4986
• Language: English
• Keywords: Intervention (counseling); Moderated mediation; Psychiatry; Psychological intervention; Baseline (sea); Health psychology; Clinical psychology; Political science; Mediation; Social psychology; Anxiety; Psychology; Public health; Medicine; Moderation