Long-term effects of an internalized weight stigma intervention: A randomized controlled trial.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of consulting and clinical psychology Pub Date : 2023-07-01 Epub Date: 2023-05-08 DOI:10.1037/ccp0000819

Rebecca L Pearl, Thomas A Wadden, Caroline Bach, Erica M LaFata, Shiva Gautam, Sharon Leonard, Robert I Berkowitz, Janet D Latner, John M Jakicic

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引用次数: 0

Abstract

Objective: To test the long-term effects of a group-based, psychological intervention designed to reduce internalized weight stigma (IWS, i.e., self-stigma), delivered in combination with behavioral weight loss (BWL) treatment, compared to BWL alone.

Method: Adults with obesity who had experienced and IWS (N = 105, M_age = 49 years, 90.5% women, 70.5% White, 24.8% Black, M_BMI = 38 kg/m²) were randomized to receive BWL with the Weight Bias Internalization and Stigma (BIAS) Program or BWL alone. Participants received weekly group treatment for 20 weeks, followed by 52 weeks of monthly and every-other-month sessions. Percent weight change at Week 72 was the primary outcome, with secondary outcomes of weight change at other time points; physical activity (measured by accelerometry, interview, and self-report); cardiometabolic risk factors; and psychological and behavioral outcomes. Intention-to-treat analyses used linear mixed models to test for between-group differences. Treatment acceptability was assessed.

Results: Participants in the BWL + BIAS versus BWL group lost 2 percentage points more of baseline weight at Week 72, which was not a significant difference (mean weight change = -7.2% vs. -5.2%, 95% CI [-4.6 to 0.6], p = 0.14, d = 0.18). The BWL + BIAS (vs. BWL) group produced significantly greater improvements in weight self-stigma, eating self-efficacy, and some aspects of quality of life at specific time points. Most outcomes improved significantly over time but did not differ between groups. The trial had high retention and treatment acceptability, with higher ratings in the BWL + BIAS versus BWL group.

Conclusions: No significant differences in weight loss were observed between the BWL + BIAS versus BWL group. Possible benefits of addressing weight stigma in weight management warrant further investigation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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内化体重污名干预的长期效果：随机对照试验

目的与单纯的行为减肥（BWL）治疗相比，旨在减少内化体重污名（IWS，即自我污名）的集体心理干预与行为减肥（BWL）治疗相结合，测试其长期效果：方法：对经历过 IWS 的成人肥胖症患者（人数 = 105，年龄 = 49 岁，90.5% 为女性，70.5% 为白人，24.8% 为黑人，MBMI = 38 kg/m²）进行随机分组，让他们接受带有体重偏差内化和成见（BIAS）计划的行为减肥治疗或单独接受行为减肥治疗。参与者每周接受一次小组治疗，为期 20 周，之后每月和每隔一个月接受一次治疗，为期 52 周。第 72 周的体重变化百分比是主要结果，次要结果包括其他时间点的体重变化、体育锻炼（通过加速度计、访谈和自我报告进行测量）、心脏代谢风险因素以及心理和行为结果。意向治疗分析采用线性混合模型检验组间差异。对治疗的可接受性进行了评估：第 72 周时，BWL + BIAS 组与 BWL 组相比，基线体重多减了 2 个百分点，差异不显著（平均体重变化 = -7.2% vs. -5.2%，95% CI [-4.6 to 0.6]，p = 0.14，d = 0.18）。BWL + BIAS 组（与 BWL 组相比）在特定时间点的体重自我耻辱感、饮食自我效能感和生活质量的某些方面都有显著改善。随着时间的推移，大多数结果都有明显改善，但组间没有差异。该试验的保留率和治疗可接受性都很高，BWL + BIAS 组的评分高于 BWL 组：BWL + BIAS 组与 BWL 组在体重减轻方面没有明显差异。在体重管理中解决体重成见可能带来的益处值得进一步研究。(PsycInfo Database Record (c) 2023 APA，保留所有权利）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.