Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA.
Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI, USA.
Ann Behav Med. 2019 Nov 9;53(12):1009-1019. doi: 10.1093/abm/kaz011.
Acceptance-based treatment (ABT) for weight loss has shown promise for improving outcomes relative to standard behavioral treatment (SBT). One way in which ABT may improve outcomes is through increasing physical activity (PA) intentions and behavior but little research has examined these as mediators of ABT on weight change.
This study sought to examine ABT's effects on intentions for PA and several objectively measured PA variables during treatment and analyze PA intentions and behaviors as mediators of ABT's effect on weight loss.
Participants (N = 189) with overweight/obesity randomized to 1 year of either ABT or SBT completed ecological momentary assessment of PA intentions, accelerometer-based PA assessment, and had weight measured at baseline, mid-treatment, and end of treatment.
ABT had a significantly higher increase than SBT in PA intention minutes at mid-treatment and end of treatment (p < 0.001), and both groups had nonlinear increases in moderate-to-vigorous physical activity (MVPA) that were not significantly different. Sequential mediation models found that ABT's effect on weight loss was partially mediated by higher PA intention minutes at mid-treatment leading to increased MVPA minutes per week. Increased MVPA minutes were obtained by participants increasing the number of days with MVPA bouts.
ABT's effect on weight loss throughout treatment resulted, in part, from participants increasing their intentions for PA. Controlling for group, higher PA intentions were associated with more PA obtained through more days with exercise.
与标准行为治疗（SBT）相比，基于接受的治疗（ABT）在改善减肥效果方面显示出了一定的前景。ABT 可能通过增加身体活动（PA）的意图和行为来改善结果，但很少有研究检查过这些意图和行为是否是 ABT 对体重变化影响的中介因素。
本研究旨在检验 ABT 在治疗期间对 PA 意图和几项客观测量的 PA 变量的影响，并分析 PA 意图和行为是否是 ABT 对减肥效果的中介因素。
超重/肥胖的参与者（N = 189）被随机分配到 1 年的 ABT 或 SBT 治疗中，他们完成了 PA 意图的生态瞬间评估、基于加速度计的 PA 评估，并在基线、治疗中期和治疗结束时测量体重。
ABT 在治疗中期和治疗结束时的 PA 意图分钟数比 SBT 有显著增加（p < 0.001），并且两组的中度到剧烈体力活动（MVPA）都呈非线性增加，但差异不显著。序贯中介模型发现，ABT 对体重减轻的影响部分通过治疗中期更高的 PA 意图分钟数来介导，从而增加了每周的 MVPA 分钟数。MVPA 分钟数的增加是通过参与者增加有 MVPA 运动的天数来实现的。
ABT 在整个治疗过程中对体重减轻的影响，部分是由于参与者增加了对 PA 的意图。控制组后，更高的 PA 意图与通过更多天数的运动获得更多的 PA 有关。
