A Mindfulness and Acceptance-based Intervention for Increasing Physical Activity and Reducing Obesity
AuthorFletcher, Lindsay B.
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The benefits of physical activity are well documented and are especially relevant for the physical and psychological difficulties associated with obesity. Physical activity is not only critical for weight loss and maintenance; regular exercise can also reduce the impact of many physical health problems, such as high blood pressure, heart disease, and Type II diabetes. Physical activity is a potent treatment for the prevention and alleviation of depression, and depression is twice as common in obese clients presenting for weight loss. Despite the benefits of exercise, only 25% of Americans meet the minimum recommended levels of physical activity. While behavioral approaches have shown to be effective for increasing physical activity, these changes are not maintained. Psychological barriers to regular exercise are the inability to persist despite discomfort (task persistence), fear of judgments from oneself and others (stigma), and a lack of enduring commitment (motivation). These are even greater for obese individuals who experience greater discomfort associated with exercise, more stigma, and a history of broken commitments, leading to inactivity, depression, and weight gain. The current study evaluated an intervention based on an empirically based behavioral approach known as Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) that targeted three psychological barriers to exercise by promoting acceptance, mindfulness, and values. Seventy-two current and former patients in a weight loss clinic were randomized to a one-day ACT intervention or a waitlist control group. They were assessed pre- and post-intervention and at follow-up three months later. While membership in the ACT group was associated with significant positive changes in physical activity, weight loss, loss of body fat, gains in muscle mass, and performance on a fitness test, there were no significant differences on outcomes between the ACT and control groups. Similarly, participants in the ACT group displayed significant improvements on measures of acceptance, distress tolerance, stigma, and values, although there were no between-group differences. The control group showed greater improvements on a measure of mindfulness, contradicting the proposed model. Thus, improvements on outcome and process measures could not be attributed to the ACT workshop. Participation in the weight loss program from which subjects were recruited may have diminished any differences between the two groups in this sample.