(PS6-B46) Weight Stigma, Mental Health, and Weight Loss: Preliminary Results from an RCT for Weight Loss Maintenance

Background: Obesity continues to be a major public health issue with personal and societal consequences. The short-term effectiveness of behavioral interventions is well established; however, innovations are still needed to improve long-term outcomes as well as greater understanding about the psychosocial factors that contribute to poorer outcomes.

Methods: This is an investigator-initiated clinical trial R01 to compare the efficacy of an intervention based on Acceptance and Commitment Therapy (ACT) and a self-regulation (SR) intervention for weight loss maintenance. All participants first complete a validated online weight loss intervention (Phase 1: months 1-3 of the study, non-randomized). Participants who lose ≥4 kilograms of initial weight are then randomly assigned to receive ACT or SR, with both conditions consisting of four face-to-face, group-based intervention meetings (10 hours total) and weekly email contact for 6 months (Phase 2). Assessments are at baseline, post-weight loss/pre-randomization, and then 6, 12, 18, 24, and 30-month follow-up. Preliminary results on short-term outcomes focusing on the role of mental health and weight stigma will be presented.

Results: 513 participants were enrolled in the online weight loss intervention with 224 advancing to the randomized weight loss maintenance phase. Baseline weight stigma was associated with baseline depression and anxiety, however none of these variables was associated with short-term weight loss. Short-term weight loss was associated with decreases in one component of weight self-stigma, self-devaluation, but not with another, fear of being stigmatized by others. Descriptive analyses show differences in these relationships based on racial and ethnic background.

Conclusion: Contrary to previous findings, initial weight stigma did not limit short-term weight loss in the full sample. However, weight stigma and mental health appeared to have a differential impact on weight loss in part based on demographic factors.