Characteristics of adults with overweight/obesity and high internal disinhibition: do they fit with targets for acceptance-based interventions?

Objective: Adults with overweight/obesity reporting high levels of internal disinhibition (ID) tend to do poorly in standard behavioural weight loss programmes. The current study sought to compare a sample of individuals with overweight/obesity selected on the basis of high ID with an unselected treatment-seeking sample of adults with overweight/obesity on characteristics that might make acceptance-based treatments particularly appropriate for those with high ID.

Methods: Sample 1 included 162 treatment-seeking adults with overweight/obesity who were selected for high ID; sample 2 included 194 unselected treatment-seeking adults with overweight/obesity. First, the two samples were compared on levels of general and weight-related experiential avoidance, and values-consistent behaviour, both of which are targeted in acceptance-based treatments, and on other general psychological characteristics. Next, the unselected sample was split into two groups, those meeting criteria for high (N = 105; sample 2/high ID) vs. low (N = 89; sample 2/low ID) ID, and the three groups were compared on the same characteristics.

Results: Sample 1 reported higher levels of both general and weight-related experiential avoidance as well as less values-consistent behaviour than sample 2. They reported greater psychological impairment in quality of life, depression and anxiety. Within sample 2, 54% met the criteria for high ID. Both sample 1 and sample 2/high ID reported higher levels of experiential avoidance and less values-consistent behaviour than did the sample 2/low ID. The two high ID samples also reported greater psychological impairment in quality of life, depression and anxiety than sample 2/low ID.

Conclusions: Adults with overweight/obesity who report high levels of ID were characterized by higher levels of experiential avoidance, lower levels of values-consistent behaviour, and more psychosocial impairment as compared with other adults with overweight/obesity. As these are important targets of acceptance-based approaches, this subgroup may benefit from the integration of such approaches into behavioural weight loss programmes.