Skip to main content
Top
Published in: Annals of Behavioral Medicine 1/2009

01-02-2009 | Original Article

Teaching Acceptance and Mindfulness to Improve the Lives of the Obese: A Preliminary Test of a Theoretical Model

Authors: Jason Lillis, Ph.D., Steven C. Hayes, Ph.D., Kara Bunting, M.A., Akihiko Masuda, Ph.D.

Published in: Annals of Behavioral Medicine | Issue 1/2009

Login to get access

Abstract

Background

Obesity is a growing epidemic. Weight control interventions can achieve weight loss, but most is regained over time. Stigma and low quality of life are significant problems that are rarely targeted.

Purpose

A new model aimed at reducing avoidant behavior and increasing psychological flexibility, has shown to be relevant in the treatment of other chronic health problems and is worth examining for improving the lives of obese persons.

Methods

Patients who had completed at least 6 months of a weight loss program (N = 84) were randomly assigned to receive a 1-day, mindfulness and acceptance-based workshop targeting obesity-related stigma and psychological distress or be placed on a waiting list.

Results

At a 3-month follow-up, workshop participants showed greater improvements in obesity-related stigma, quality of life, psychological distress, and body mass, as well as improvements in distress tolerance, and both general and weight-specific acceptance and psychological flexibility. Effects on distress, stigma, and quality of life were above and beyond the effects due to improved weight control. Mediational analyses indicated that changes in weight-specific acceptance coping and psychological flexibility mediated changes in outcomes.

Conclusion

Results provide preliminary support for the role of acceptance and mindfulness in improving the quality of life of obese individuals while simultaneously augmenting their weight control efforts.
Literature
2.
go back to reference Hedley AA, Odgen CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004; 291: 1847–1850.CrossRef Hedley AA, Odgen CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004; 291: 1847–1850.CrossRef
3.
go back to reference Finkelstein EA, Fiebelkorn IC, Wang GJ. National medical spending attributable to overweight and obesity: How much, and who’s paying? Health Aff. 2003; 22: W219–W226. Finkelstein EA, Fiebelkorn IC, Wang GJ. National medical spending attributable to overweight and obesity: How much, and who’s paying? Health Aff. 2003; 22: W219–W226.
4.
go back to reference Avenell A, Brown TJ, McGee MA, et al. What are the long-term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials. J. Hum. Nutr. Diet. 2004; 17: 317–335.PubMedCrossRef Avenell A, Brown TJ, McGee MA, et al. What are the long-term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials. J. Hum. Nutr. Diet. 2004; 17: 317–335.PubMedCrossRef
5.
go back to reference Perri MG, Corisca JA. Improving the maintenance of weight loss in behavioral treatment of obesity. In: Wadden TA, Stunkard AJ, eds. Handbook of obesity treatment. New York: Guilford Press; 2002. Perri MG, Corisca JA. Improving the maintenance of weight loss in behavioral treatment of obesity. In: Wadden TA, Stunkard AJ, eds. Handbook of obesity treatment. New York: Guilford Press; 2002.
6.
go back to reference Wilson GT, Brownell KD. Behavioral treatment for obesity. In: Fairburn CG, Brownell KD, eds. Eating Disorders and Obesity. New York: Guilford Press; 2002. Wilson GT, Brownell KD. Behavioral treatment for obesity. In: Fairburn CG, Brownell KD, eds. Eating Disorders and Obesity. New York: Guilford Press; 2002.
7.
go back to reference Anderson JW, Vichitbandra S, Qian W, Kryscio RJ. Long-term weight maintenance after an intensive weight-loss program. J Am Coll Nutr. 1999; 18: 620–627.PubMed Anderson JW, Vichitbandra S, Qian W, Kryscio RJ. Long-term weight maintenance after an intensive weight-loss program. J Am Coll Nutr. 1999; 18: 620–627.PubMed
8.
go back to reference Wadden TA, Frey DL. A multicenter evaluation of a proprietary weight loss program for the treatment of marked obesity: A five-year follow-up. Int J Eat Disord. 1997; 22: 203–212.PubMedCrossRef Wadden TA, Frey DL. A multicenter evaluation of a proprietary weight loss program for the treatment of marked obesity: A five-year follow-up. Int J Eat Disord. 1997; 22: 203–212.PubMedCrossRef
9.
go back to reference Drapkin RG, Wing RR, Shiffman S. Responses to hypothetical high-risk situations: Do they predict weight-loss in a behavioral treatment program or the context of dietary lapses. Health Psychol. 1995; 14: 427–434.PubMedCrossRef Drapkin RG, Wing RR, Shiffman S. Responses to hypothetical high-risk situations: Do they predict weight-loss in a behavioral treatment program or the context of dietary lapses. Health Psychol. 1995; 14: 427–434.PubMedCrossRef
10.
go back to reference Byrne S, Cooper Z, Fairburn C. Weight maintenance and relapse in obesity: A qualitative study. Int J Obes. 2003; 27: 955–962.CrossRef Byrne S, Cooper Z, Fairburn C. Weight maintenance and relapse in obesity: A qualitative study. Int J Obes. 2003; 27: 955–962.CrossRef
11.
go back to reference Kayman S, Bruvold W, Stern JS. Maintenance and relapse after weight-loss in women: Behavioral aspects. Am J Clin Nutr. 1990; 52: 800–807.PubMed Kayman S, Bruvold W, Stern JS. Maintenance and relapse after weight-loss in women: Behavioral aspects. Am J Clin Nutr. 1990; 52: 800–807.PubMed
12.
go back to reference Fassino S, Leombruni P, Piero A, et al. Temperament and character in obese women with and without binge eating disorder. Compr Psychiatry. 2002; 43: 431–437.PubMedCrossRef Fassino S, Leombruni P, Piero A, et al. Temperament and character in obese women with and without binge eating disorder. Compr Psychiatry. 2002; 43: 431–437.PubMedCrossRef
13.
go back to reference Ryden A, Sullivan M, Torgerson JS, Karlsson J, Lindroos AK, Taft C. Severe obesity and personality: A comparative controlled study of personality traits. Int J Obes. 2003; 27: 1534–1540.CrossRef Ryden A, Sullivan M, Torgerson JS, Karlsson J, Lindroos AK, Taft C. Severe obesity and personality: A comparative controlled study of personality traits. Int J Obes. 2003; 27: 1534–1540.CrossRef
14.
go back to reference Ganley RM. Emotion and eating in obesity: A review of the literature. Int J Eat Disord. 1989; 8: 343–361.CrossRef Ganley RM. Emotion and eating in obesity: A review of the literature. Int J Eat Disord. 1989; 8: 343–361.CrossRef
15.
go back to reference Ferguson KJ, Brink PJ, Wood M, Koop PM. Characteristics of successful dieters as measured by guided interview responses and restraint scale scores. J Am Diet Assoc. 1992; 92: 1119–1121.PubMed Ferguson KJ, Brink PJ, Wood M, Koop PM. Characteristics of successful dieters as measured by guided interview responses and restraint scale scores. J Am Diet Assoc. 1992; 92: 1119–1121.PubMed
16.
go back to reference Westenhoefer J. The therapeutic challenge: Behavioral changes for long-term weight maintenance. Int J Obes. 2001; 25: S85–S88.CrossRef Westenhoefer J. The therapeutic challenge: Behavioral changes for long-term weight maintenance. Int J Obes. 2001; 25: S85–S88.CrossRef
17.
go back to reference Bennett GA. Behavior-therapy for obesity: A quantitative review of the effects of selected treatment characteristics on outcome. Behav Ther. 1986; 17: 554–562.CrossRef Bennett GA. Behavior-therapy for obesity: A quantitative review of the effects of selected treatment characteristics on outcome. Behav Ther. 1986; 17: 554–562.CrossRef
18.
go back to reference Glenny AM, Omeara S, Melville A, Sheldon TA, Wilson C. The treatment and prevention of obesity: A systematic review of the literature. Int J Obes. 1997; 21: 715–737.CrossRef Glenny AM, Omeara S, Melville A, Sheldon TA, Wilson C. The treatment and prevention of obesity: A systematic review of the literature. Int J Obes. 1997; 21: 715–737.CrossRef
19.
go back to reference Brownell KD, Puhl RM, Schwartz MB, Rudd L. Weight bias: Nature, consequences, remedies. New York, NY: Guilford Publications; 2005. Brownell KD, Puhl RM, Schwartz MB, Rudd L. Weight bias: Nature, consequences, remedies. New York, NY: Guilford Publications; 2005.
20.
go back to reference Garner DM, Wooley SC. Confronting the failure of behavioral and dietary treatments for obesity. Clin Psychol Rev. 1991; 11: 729–780.CrossRef Garner DM, Wooley SC. Confronting the failure of behavioral and dietary treatments for obesity. Clin Psychol Rev. 1991; 11: 729–780.CrossRef
21.
go back to reference Wooley SC, Garner DM. Controversies in management: Dietary treatments for obesity are ineffective. BMJ. 1994; 309: 655–656.PubMed Wooley SC, Garner DM. Controversies in management: Dietary treatments for obesity are ineffective. BMJ. 1994; 309: 655–656.PubMed
22.
go back to reference Falkner NH, French SA, Jeffery RW, Neumark-Sztainer D, Sherwood NE, Morton N. Mistreatment due to weight: Prevalence and sources of perceived mistreatment in women and men. Obes Res. 1999; 7: 572–576.PubMed Falkner NH, French SA, Jeffery RW, Neumark-Sztainer D, Sherwood NE, Morton N. Mistreatment due to weight: Prevalence and sources of perceived mistreatment in women and men. Obes Res. 1999; 7: 572–576.PubMed
23.
go back to reference Puhl R, Brownell KD. Psychosocial origins of obesity stigma: Toward changing a powerful and pervasive bias. Obes Rev. 2003; 4: 213–227.PubMedCrossRef Puhl R, Brownell KD. Psychosocial origins of obesity stigma: Toward changing a powerful and pervasive bias. Obes Rev. 2003; 4: 213–227.PubMedCrossRef
25.
go back to reference Gifford EV, Kohlenberg BS, Hayes SC, et al. Acceptance theory-based treatment for smoking cessation: An initial trial of Acceptance and Commitment Therapy. Behav Ther. 2004; 35: 689–706.CrossRef Gifford EV, Kohlenberg BS, Hayes SC, et al. Acceptance theory-based treatment for smoking cessation: An initial trial of Acceptance and Commitment Therapy. Behav Ther. 2004; 35: 689–706.CrossRef
26.
go back to reference Gifford EV, Ritsher J, McKellar J, Moos R. Acceptance and relationship context: A model of substance use disorder treatment outcome. Addiction. 2006; 101: 1167–1177.PubMedCrossRef Gifford EV, Ritsher J, McKellar J, Moos R. Acceptance and relationship context: A model of substance use disorder treatment outcome. Addiction. 2006; 101: 1167–1177.PubMedCrossRef
27.
go back to reference Hayes SC, Wilson KG, Gifford EV, et al. A preliminary trial of Twelve-Step Facilitation and Acceptance and Commitment Therapy with poly-substance abusing methadone-maintained opiate addicts. Behav Ther. 2004; 35: 667–688.CrossRef Hayes SC, Wilson KG, Gifford EV, et al. A preliminary trial of Twelve-Step Facilitation and Acceptance and Commitment Therapy with poly-substance abusing methadone-maintained opiate addicts. Behav Ther. 2004; 35: 667–688.CrossRef
28.
go back to reference McCracken LM, Vowles KE, Eccleston C. Acceptance-based treatment for persons with complex, long-standing chronic pain: A preliminary analysis of treatment outcome in comparison to a waiting phase. Behav Res Ther. 2005; 43: 1335–1346.PubMedCrossRef McCracken LM, Vowles KE, Eccleston C. Acceptance-based treatment for persons with complex, long-standing chronic pain: A preliminary analysis of treatment outcome in comparison to a waiting phase. Behav Res Ther. 2005; 43: 1335–1346.PubMedCrossRef
29.
go back to reference Forman EM, Hoffman KL, McGrath KB, Herbert JD, Brandsma LL, Lowe MR. A comparison of acceptance and control-based strategies for coping with food cravings: An analog study. Behav Res Ther. 2007; 45: 2372–2386.PubMedCrossRef Forman EM, Hoffman KL, McGrath KB, Herbert JD, Brandsma LL, Lowe MR. A comparison of acceptance and control-based strategies for coping with food cravings: An analog study. Behav Res Ther. 2007; 45: 2372–2386.PubMedCrossRef
30.
go back to reference Brownell KD. The LEARN program for weight management. Dallas, TX: American Health; 2000. Brownell KD. The LEARN program for weight management. Dallas, TX: American Health; 2000.
31.
go back to reference Hayes SC, Strosahl K, Wilson KG. Acceptance and Commitment Therapy: An experiential approach to behavior change. New York, NY: The Guilford Press; 1999. Hayes SC, Strosahl K, Wilson KG. Acceptance and Commitment Therapy: An experiential approach to behavior change. New York, NY: The Guilford Press; 1999.
32.
go back to reference Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and Commitment Therapy: Model, processes, and outcomes. Behav Res Ther. 2006; 44: 1–25.PubMedCrossRef Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and Commitment Therapy: Model, processes, and outcomes. Behav Res Ther. 2006; 44: 1–25.PubMedCrossRef
33.
go back to reference Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K. Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996; 64: 1152–1168.PubMedCrossRef Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K. Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996; 64: 1152–1168.PubMedCrossRef
34.
go back to reference Westenhoefer J, Stunkard AJ, Pudel V. Validation of the flexible and rigid control dimensions of dietary restraint. Int J Eat Disord. 1999; 26: 53–64.PubMedCrossRef Westenhoefer J, Stunkard AJ, Pudel V. Validation of the flexible and rigid control dimensions of dietary restraint. Int J Eat Disord. 1999; 26: 53–64.PubMedCrossRef
35.
go back to reference Hayes SC, Bissett R, Roget N, et al. The impact of acceptance and commitment training and multicultural training on the stigmatizing attitudes and professional burnout of substance abuse counselors. Behav Ther. 2004; 35: 821–835.CrossRef Hayes SC, Bissett R, Roget N, et al. The impact of acceptance and commitment training and multicultural training on the stigmatizing attitudes and professional burnout of substance abuse counselors. Behav Ther. 2004; 35: 821–835.CrossRef
36.
go back to reference Luoma JB, Kohlenberg BS, Hayes SC, Bunting K, Rye AK. Reducing the self stigma of substance abuse through acceptance and commitment therapy: Model, manual development, and pilot outcomes. Addiction Res Ther. In press. Luoma JB, Kohlenberg BS, Hayes SC, Bunting K, Rye AK. Reducing the self stigma of substance abuse through acceptance and commitment therapy: Model, manual development, and pilot outcomes. Addiction Res Ther. In press.
37.
go back to reference Lillis J, Hayes SC. Applying acceptance, mindfulness, and values to the reduction of prejudice. Behav Modif. 2007; 31: 389–411.PubMedCrossRef Lillis J, Hayes SC. Applying acceptance, mindfulness, and values to the reduction of prejudice. Behav Modif. 2007; 31: 389–411.PubMedCrossRef
38.
go back to reference Masuda A, Hayes SC, Fletcher LB, et al. The impact of Acceptance and Commitment Therapy versus education on stigma toward people with psychological disorders. Beh Res Ther. In press. Masuda A, Hayes SC, Fletcher LB, et al. The impact of Acceptance and Commitment Therapy versus education on stigma toward people with psychological disorders. Beh Res Ther. In press.
39.
go back to reference Dahl J, Wilson KG, Nilsson A. Acceptance and Commitment Therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: A preliminary randomized trial. Behav Ther. 2004; 35: 785–802.CrossRef Dahl J, Wilson KG, Nilsson A. Acceptance and Commitment Therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: A preliminary randomized trial. Behav Ther. 2004; 35: 785–802.CrossRef
40.
go back to reference Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. J Consult Clin Psychol. 2007; 75: 336–343.PubMedCrossRef Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. J Consult Clin Psychol. 2007; 75: 336–343.PubMedCrossRef
41.
go back to reference Lundgren TA, Dahl J, Melin L, Kies B. Evaluation of Acceptance and Commitment Therapy for drug refractory epilepsy: A randomized control trial in South Africa: A pilot study. Epilepsia. 2006; 47: 2173–2179.PubMedCrossRef Lundgren TA, Dahl J, Melin L, Kies B. Evaluation of Acceptance and Commitment Therapy for drug refractory epilepsy: A randomized control trial in South Africa: A pilot study. Epilepsia. 2006; 47: 2173–2179.PubMedCrossRef
42.
go back to reference Brown RA, Palm KM, Strong DR, et al. Distress tolerance treatment for early lapse smokers: Rationale, program description and preliminary findings. Behav Modif. In press. Brown RA, Palm KM, Strong DR, et al. Distress tolerance treatment for early lapse smokers: Rationale, program description and preliminary findings. Behav Modif. In press.
43.
go back to reference Hayes SC. Smith S. Get out of your mind and into your life: The new Acceptance and Commitment Therapy. Oakland, CA: New Harbinger; 2005. Hayes SC. Smith S. Get out of your mind and into your life: The new Acceptance and Commitment Therapy. Oakland, CA: New Harbinger; 2005.
44.
go back to reference Goldberg DP. The detection of psychiatric illness by questionnaire. London: Oxford University Press; 1972. Goldberg DP. The detection of psychiatric illness by questionnaire. London: Oxford University Press; 1972.
45.
go back to reference Goldberg DP, Gater R, Sartorius N, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997; 27: 191–197.PubMedCrossRef Goldberg DP, Gater R, Sartorius N, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997; 27: 191–197.PubMedCrossRef
46.
go back to reference Mannucci E, Ricca V, Barciulli E, et al. Quality of life and overweight: The Obesity Related Well-Being (ORWELL 97) Questionnaire. Addictive Behaviors. 1999; 24: 345–357.PubMedCrossRef Mannucci E, Ricca V, Barciulli E, et al. Quality of life and overweight: The Obesity Related Well-Being (ORWELL 97) Questionnaire. Addictive Behaviors. 1999; 24: 345–357.PubMedCrossRef
47.
go back to reference Lillis J. Acceptance and Commitment Therapy for the treatment of obesity-related stigma and weight control. Unpublished doctoral dissertation, University of Nevada, Reno; 2007. Lillis J. Acceptance and Commitment Therapy for the treatment of obesity-related stigma and weight control. Unpublished doctoral dissertation, University of Nevada, Reno; 2007.
48.
go back to reference Rosenberg M. Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press; 1965. Rosenberg M. Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press; 1965.
49.
go back to reference Ritsher JB, Otilingam PG, Grajales M. Internalized stigma of mental illness: Psychometric properties of a new measure. Psychiatry Res. 2003; 121: 31–49.PubMedCrossRef Ritsher JB, Otilingam PG, Grajales M. Internalized stigma of mental illness: Psychometric properties of a new measure. Psychiatry Res. 2003; 121: 31–49.PubMedCrossRef
50.
go back to reference Myers A, Rosen JC. Obesity stigmatization and coping: Relation to mental health, symptoms, body image, and self-esteem. Int J Obes. 1999; 23: 221–230.CrossRef Myers A, Rosen JC. Obesity stigmatization and coping: Relation to mental health, symptoms, body image, and self-esteem. Int J Obes. 1999; 23: 221–230.CrossRef
51.
go back to reference Allison DB, Basile VC, Yuker HE. The measurement of attitudes and beliefs about obese persons. Int J Eat Disord. 1991; 10: 599–607. Allison DB, Basile VC, Yuker HE. The measurement of attitudes and beliefs about obese persons. Int J Eat Disord. 1991; 10: 599–607.
52.
go back to reference St. Jeor ST, Brunner RL, Harrington ME, et al. A classification system to evaluate weight maintainers, gainers, and losers. J Am Diet Assoc. 1997; 97: 481–488.PubMedCrossRef St. Jeor ST, Brunner RL, Harrington ME, et al. A classification system to evaluate weight maintainers, gainers, and losers. J Am Diet Assoc. 1997; 97: 481–488.PubMedCrossRef
53.
go back to reference Hayes SC, Strosahl KD, Wilson KG, et al. Measuring experiential avoidance: A preliminary test of a working model. Psychol Rec. 2004; 54: 553–578. Hayes SC, Strosahl KD, Wilson KG, et al. Measuring experiential avoidance: A preliminary test of a working model. Psychol Rec. 2004; 54: 553–578.
54.
go back to reference Lillis J, Hayes SC. Measuring avoidance and inflexibility in weight related problems. Int J Behav Consult Ther. 2008; 4: 30–40. Lillis J, Hayes SC. Measuring avoidance and inflexibility in weight related problems. Int J Behav Consult Ther. 2008; 4: 30–40.
55.
go back to reference Brown RA, Leuez CW, Kahler CW, Strong DR, Zvolensky MJ. Distress tolerance and early smoking lapse. Clin Psychol Rev. 2005; 25: 713–733.PubMedCrossRef Brown RA, Leuez CW, Kahler CW, Strong DR, Zvolensky MJ. Distress tolerance and early smoking lapse. Clin Psychol Rev. 2005; 25: 713–733.PubMedCrossRef
56.
go back to reference Cohen JC. Quantitative methods in psychology: A power primer. Psychol Bull. 1992; 112: 155–159.CrossRef Cohen JC. Quantitative methods in psychology: A power primer. Psychol Bull. 1992; 112: 155–159.CrossRef
57.
go back to reference MacKinnon DP, Lockwood CM, Hoffman JM, West SG, Sheets V. A comparison of methods to test mediation and other intervening variables. Psychol Methods. 2002; 7: 83–104.PubMedCrossRef MacKinnon DP, Lockwood CM, Hoffman JM, West SG, Sheets V. A comparison of methods to test mediation and other intervening variables. Psychol Methods. 2002; 7: 83–104.PubMedCrossRef
58.
go back to reference MacKinnon DP, Warsi G, Dwyer JH. A simulation study of mediated effect measures. Multivariate Behav Res. 1995; 30: 41–62.CrossRef MacKinnon DP, Warsi G, Dwyer JH. A simulation study of mediated effect measures. Multivariate Behav Res. 1995; 30: 41–62.CrossRef
59.
go back to reference Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. J Pers Soc Psychol. 1986; 51: 1173–1182.PubMedCrossRef Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. J Pers Soc Psychol. 1986; 51: 1173–1182.PubMedCrossRef
60.
go back to reference Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. In: Leinhardt S. ed. Sociological Methodlogy. Washington, DC: American Sociological Association; 1982. Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. In: Leinhardt S. ed. Sociological Methodlogy. Washington, DC: American Sociological Association; 1982.
61.
go back to reference Preacher KJ, Hayes AF. SPSS and SAS Procedures for estimating effects in simple mediation models. Behav Res Meth Instrum Comput. 2004; 36: 717–731. Preacher KJ, Hayes AF. SPSS and SAS Procedures for estimating effects in simple mediation models. Behav Res Meth Instrum Comput. 2004; 36: 717–731.
62.
go back to reference Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. In press. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. In press.
63.
64.
go back to reference Bach P, Hayes SC. The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. J Consult Clin Psychol. 2002; 70: 1129–1139.PubMedCrossRef Bach P, Hayes SC. The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. J Consult Clin Psychol. 2002; 70: 1129–1139.PubMedCrossRef
Metadata
Title
Teaching Acceptance and Mindfulness to Improve the Lives of the Obese: A Preliminary Test of a Theoretical Model
Authors
Jason Lillis, Ph.D.
Steven C. Hayes, Ph.D.
Kara Bunting, M.A.
Akihiko Masuda, Ph.D.
Publication date
01-02-2009
Publisher
Springer-Verlag
Published in
Annals of Behavioral Medicine / Issue 1/2009
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-009-9083-x

Other articles of this Issue 1/2009

Annals of Behavioral Medicine 1/2009 Go to the issue