Call Christine C, D'Adamo Laura, Crane Nicole T, Hagerman Charlotte J, Butryn Meghan L
Center for Weight, Eating, and Lifestyle Sciences (WELL Center) and Department of Psychological and Brain Sciences, Drexel University 3141 Chestnut St, Stratton Hall Suite 119, Philadelphia, PA 19104, USA.
Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
J Contextual Behav Sci. 2022 Apr;24:60-64. doi: 10.1016/j.jcbs.2022.03.008. Epub 2022 Mar 23.
Biological, genetic, and environmental factors make weight loss very difficult. Acceptance-based behavioral treatment (ABT) supplements standard behavioral treatments (BT) for obesity by teaching skills to accept the discomfort inherent to weight control behaviors and prioritize long-term, values-based goals. Grit, the ability to persevere in goal pursuit, overlaps conceptually with ABT principles and may predict outcomes in ABT. During a randomized controlled trial comparing three weight loss interventions (BT, BT with an emphasis on physical activity [BT+PA], ABT with an emphasis on physical activity [ABT+PA]), this study examined if grit predicted weight loss, intervention engagement (session attendance and dietary self-monitoring), and perceived intervention effectiveness, and whether intervention condition moderated these relationships. Participants (=309) with overweight/obesity enrolled in an 18-month weight loss intervention completed the Short Grit Scale at baseline. Weight and PA were measured at baseline, during the intervention (12 and 18 months), and at follow-up (24 and 36 months). Session attendance and dietary self-monitoring were assessed throughout the intervention, and perceived intervention effectiveness at end-of-intervention. The relation of grit to several outcomes depended on condition. In ABT+PA, but not BT or BT+PA, grit related to weight loss at 12 and 24 months, session attendance, and perceived intervention effectiveness. Grit was not related to PA or dietary self-monitoring in any condition. ABT's focus on building skills to facilitate long-term goal pursuit may be unique and beneficial to those with lower grit. Those with higher grit may already possess ABT-consistent skills and benefit less from ABT. Research on trait-level characteristics like grit in relation to weight must be cautious not to reinforce weight bias; rather, this work suggests that an evidence-based intervention (ABT) may be well-suited to those with lower grit levels seeking weight loss.
生物、遗传和环境因素使得减肥非常困难。基于接纳的行为疗法（ABT）通过教授技能来接纳体重控制行为中固有的不适感，并优先考虑基于价值观的长期目标，以此补充肥胖症的标准行为疗法（BT）。毅力，即坚持追求目标的能力，在概念上与ABT原则重叠，并且可能预测ABT的治疗效果。在一项比较三种减肥干预措施（BT、强调体育活动的BT[BT+PA]、强调体育活动的ABT[ABT+PA]）的随机对照试验中，本研究考察了毅力是否能预测体重减轻、干预参与度（课程出席率和饮食自我监测）以及感知到的干预效果，以及干预条件是否调节了这些关系。309名超重/肥胖参与者参加了一项为期18个月的减肥干预，在基线时完成了简短毅力量表。在基线、干预期间（12个月和18个月）以及随访（24个月和36个月）时测量体重和体育活动情况。在整个干预过程中评估课程出席率和饮食自我监测情况，并在干预结束时评估感知到的干预效果。毅力与几个结果之间的关系取决于干预条件。在ABT+PA组中，但在BT组或BT+PA组中并非如此，毅力与12个月和24个月时的体重减轻、课程出席率以及感知到的干预效果相关。在任何条件下，毅力与体育活动或饮食自我监测均无关。ABT注重培养促进长期目标追求的技能，这可能对毅力较低的人具有独特的益处。毅力较高的人可能已经具备与ABT一致的技能，从ABT中获益较少。关于像毅力这样的特质水平特征与体重关系的研究必须谨慎，以免强化体重偏见；相反，这项研究表明，一种循证干预措施（ABT）可能非常适合那些毅力较低且寻求减肥的人。
