Evidence mapPaperPMID 40451242Full record

SynthesisAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine2025

An individual participant data meta-analysis investigating the mediating role of eating behavior traits in Acceptance and Commitment Therapy-based weight management interventions.

Laura Kudlek, Julia Mueller, Patricia Eustachio Colombo, Stephen J Sharp, Clare E Boothby, Simon J Griffin, Meghan Butryn, Christina Chwyl, Evan Forman, Charlotte Hagerman and 12 more

Abstract readMeta-Analysis
In one paragraph

Synthesis in Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Laura KudlekMRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.ORCID 0000-0003-0947-3640
Julia MuellerMRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.ORCID 0000-0002-4939-7112
Patricia Eustachio ColomboMRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
Stephen J SharpMRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
Clare E BoothbyMRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
Simon J GriffinMRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
Meghan ButrynDepartment of Psychology, Drexel University, Philadelphia, PA 19104, United States.
Christina ChwylDepartment of Psychology, Drexel University, Philadelphia, PA 19104, United States.
Evan FormanDepartment of Psychology, Drexel University, Philadelphia, PA 19104, United States.ORCID 0000-0001-7233-1384
Charlotte HagermanDepartment of Psychology, Drexel University, Philadelphia, PA 19104, United States.
Misty HawkinsDepartment of Health and Wellness Design, School of Public Health, Indiana University, Bloomington, IN 47405, United States.
Adrienne JuarascioDepartment of Psychology, Drexel University, Philadelphia, PA 19104, United States.
Bärbel KnäuperDepartment of Psychology, McGill University, Montreal, Quebec, H3A 1G1, Canada.
Marjukka KolehmainenInstitute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, FI-70211, Finland.ORCID 0000-0002-3770-2538
Michael E LevinDepartment of Psychology, Utah State University, Logan, UT 84322, United States.
Jason LillisThe Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02912,United States.
Edurne MaizDepartment of Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Donostia-San Sebastian, Basque Country, 20018, Spain.
Stephanie ManasseDepartment of Psychology, Drexel University, Philadelphia, PA 19104, United States.
Lara PalmeiraRISE-Health, Department of Psychology and Education, Universidade Portucalense Infante D. Henrique, Rua Dr. António Bernardino de Almeida, Porto, 4200-319, Portugal.
Kirsi H PietiläinenObesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, FI-00014, Finland.
Nancy E SherwoodDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, United States.
Amy AhernMRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.

Funding

Cambridge Biomedical Research CentreMedical Research Council MC_UU_00006/6National Institute for Health and Care Research NIHR203312
6 · The paper itself

Abstract

backgroundIdentifying mechanisms of action can aid the refinement of weight management interventions. Acceptance and Commitment Therapy (ACT)-based interventions may support long-term weight management by improving self-regulation of eating behavior traits (EBTs). However, it remains unclear if changing EBTs like emotional eating, external eating, internal disinhibition, and restraint during ACT causes improved weight management.

methodsFor this 1-stage Individual Participant Data (IPD) meta-analysis, we requested IPD from 9 trials identified through a systematic search of ACT-based interventions for adults with a body mass index >25 kg/m2 across 8 databases until June 20, 2022. We obtained, checked, and harmonized data from 8 of those trials (N = 1391) and conducted separate structural equation models with complex survey analysis to estimate short- and long-term mediating effects of changes in each EBT on percent weight change.

resultsIn the short-term (ie, follow-up closest to intervention end), we found indirect effects of the intervention on percent weight change through changes in emotional eating, external eating, internal disinhibition, and restraint. Each 1-unit change in these EBTs led to a 0.02% (95% CI, 0.05-0.001), 0.03% (95% CI, 0.06-0.001), 0.05% (95% CI, 0.11-0.02), and 0.09% (95% CI, 0.14-0.04) decrease in weight, respectively. In the long term (ie, 12 months after intervention end), we found both indirect and total effects for emotional eating, internal disinhibition, and restraint, with EBT changes explaining 23.78%, 23.12%, and 25.64% of total effects.

conclusionFindings suggest small partial mediating effects of ACT on weight through EBTs. Targeting EBTs may support improved weight management outcomes, particularly in the long term.

Indexed as

Acceptance and Commitment TherapyFeeding BehaviorObesityWeight Reduction ProgramsAdultHumansSelf-ControlAcceptance and Commitment Therapyeating behavior traitsmechanisms of actionweight management

Identifiers

PMID40451242
PMCPMC12169333

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.