Lose Weight with Self-Regulation Behavioral Treatment

by Amy Hendel, P.A. Health Writer

Credit: Young Jun, HealthCentral

A 12-month study published in Obesity compared acceptance-based weight loss treatment (ABT) to traditional or standard behavioral therapy (SBT) to see if one approach was superior for weight loss. The results suggest that self-regulated eating practices and activity skills do beat SBT when it comes to maximizing weight loss.

In the study, 190 overweight and obese subjects (BMI range of 27-50) received either standard cognitive behavioral therapy or ABT. The goal of ABT is to learn skill sets that support self-regulating food consumption, especially when faced with the “drive” to eat high calorie foods or when bombarded with never-ending food temptations, food ads, cravings, and emotional cues that demand food as a calming antidote. The research goal was to determine whether patients who can learn ABT will be able to lose significant amounts of weight and then sustain that weight loss by continuing to use ABT techniques and insights.

Standard behavioral weight loss therapy typically involves teaching patients the basic guidelines of calorie restriction, portion control, and ways to substitute non-food behaviors when faced with cravings and emotions that often instigate feeding — even when you're not hungry. It also offers basic exercise guidance and the rules of energy balance, meaning that you somehow have to create a calorie deficit so you utilize your own body fat and burn calories. Patients are given proven skill sets to manage new lifestyle habits.

maximize weight loss study

Credit: Young Jun, HealthCentral

In this study, the group that was assigned to learn and usBere taught behavioral intervention skills sourced from the Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (a form of cognitive behavioral therapy), and Relapse Prevention for Substance Abuse (a mindfulness-based approach). This group of subjects set their own personalized goals (to be more active as a grandparent, for example) and they were taught to manage the discomfort associated with urges, cravings, emotion swings, and unpleasant exercise.

They also were taught to embrace the decreased pleasure that often accompanies managing one's weight (eating less, passing on treats, etc.) and to be sensitive to and aware of the myriad decisions to be made during waking hours when one is trying to lose weight. (Deciding to get up and exercise even after a long, exhausting day at work, for example.)

This was the first study to compare ABT to the gold standard of behavioral therapy head-to-head in a randomized study with a large group of participants.** At the end of the study, the ABT group had achieved greater weight loss (13.3 percent of body weight) compared to the group that used traditional behavioral therapies (9.8 percent of body weight lost). The researchers also noted that on average, the ABT group was better at achieving the weight goals they personally set.**

The standard group hit “the wall,” so to speak, before week 35 of the year-long study, and many began to regain week at around week 35. The researchers also suggest that the acceptance-based treatment group may have had better outcomes because of certain techniques they learned, like acceptance of the fact that they are always going to have food-related urges and the fact that they are “in charge” of their weight destiny.

The researchers acknowledge that one significant limitation of the study is that participants that enrolled were highly motivated, which is clearly not always the case when any type of behavioral therapy is being offered to a patient struggling with obesity. But this newer and optimized version of personalized behavioral therapy seems to be a better version of the previous gold standard of regular behavioral therapy.

self regulation for weight loss

Credit: Young Jun, HealthCentral

What does self-regulation mean?

Subjects in the ABT group were taught that discomfort is likely to be a frequent feeling during the process of losing weight: you will feel deprivation, exercise may cause some levels of pain, and being in a social situation can be uncomfortable when trying to limit calories. The participants in the ABT group were primed to feel reduced pleasure because so much of their life’s joy was tied to the pleasure of eating large quantities of food and treats. Subjects were taught to be mindfully engaged “in the moment” when making food decisions and selections. They were taught to commit to many of the behaviors they previously dismissed, like getting up and moving around more throughout the day, watching less TV, and so on.

Collecting and maintaining these new skill sets, coupled with mindfulness and acceptance (of weight and eating realities) were found to result in excellent weight loss results.** Additional techniques that support ABT include:**

  • Limiting temptations in your home and work environment as much as possible

  • Buying processed foods in single-serve packages

  • Using measuring cups and other tools to measure portions, and using accepted visual cues (deck of cards for serving of protein, for example) when you eat out

  • Building a support team that can help you during challenging times

  • Making sure your family and friends understand how serious the weight loss commitment is to you.

ABT also may be an effective way to navigate the holidays when for so many weeks you face endless food temptations. A time-sensitive goal to simply hold your current weight in check, rather than trying to lose weight during the holidays, might be be more realistic.

Amy Hendel, also known as The HealthGal, is a Physician Assistant, nutritionist and fitness expert. As a health media personality, she's been reporting and blogging on lifestyle issues and health news for over 20 years. Author of The 4 Habits of Healthy Families, her website offers daily health reports, links to her blogs, and a library of lifestyle video segments.

Amy Hendel, P.A.
Meet Our Writer
Amy Hendel, P.A.

Known as "The HealthGal", Amy Hendel P.A. is a medical and lifestyle reporter, nutrition and fitness expert, health coach and brand ambassador. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, find her on Twitter @Healthgal1103 and on Facebook @TheHealthGal. Check “Daily Health News” at healthgal.com. Her personal mantra? “Fix it first with food, fitness, and lifestyle.”