How to boost your weight loss efforts by 36 percent

The results of a new weight loss study are rather promising…

The approach is based on acceptance of new behaviors in relation to food, the feelings of hunger, and one’s daily activity.

This study found a 36% clinically significant improvement in weight loss with behavioral interventions through promotion of self-regulating eating and activity skills, as compared with the control group who followed standard weight loss methods alone.

The weight loss trial was headed by Prof. Evan M. Forman and colleagues of Drexel University in Philadelphia, and it lasted one year. There were 190 overweight and obese participants and randomized them into two groups: 90 were assigned to the standard behavior treatment group and 100 were assigned to the acceptance-based treatment group.

While all participants were taught certain behavioral teaching interventions such as calorie counting, diet and exercise recommendations, the acceptance-based treatment group received supplementary training gathered from Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy, and Relapse Prevention for Substance Abuse.

By the end of the trial, the acceptance-based treatment group lost 13.3% body weight while the standard weight loss group only lost 9.8% bodyweight, on average. Again, showing a 36% improvement in weight loss with the acceptance-based approach.

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The most effective wellness strategy for long-term success is one rooted in lifestyle changes and self-discipline. Yet, these are very difficult to maintain, especially because willpower is so fragile. As I previously wrote, you must ditch will power for willingness, which is an entirely different approach to wellness. In reviewing the acceptance-based model, it sounded an awful lot like willpower; but I wasn’t sure. So I reached out to Prof. Forman and asked him several questions in follow up to his study. His responses are reassuring.

What are the basic tenets of Acceptance- and Commitment-based Intervention for weight loss?

The basic tenet of acceptance-based behavioral treatment (ABT) that our biology combined with the modern environment make it exceptionally difficult to make and sustain the lifestyle changes needed to lose weight (and keep it off).  As such, we need a set of specialized psychological skills in order to be successful.  These skills include developing a clear sense of our ultimate values (what big ideas should guide our decisions), the ability to have these values in mind when making eating and physical activity decisions, and an ability to accept psychological discomfort/a reduction in pleasure, such that we can make values-consistent choices (like choosing to eat a fruit salad instead of ice cream) even if doing so results in discomfort or a loss of pleasure.

What are the key differences between this model and standard Behavior-based Intervention for weight loss?

Standard intervention has more emphasis on what to do (how to eat differently in order to reduce energy intake, how to exercise more to increase energy expenditure).  ABT believes those changes are 100% essential, but that they aren’t enough.  We also need special psychological skills in order to be successful at making those changes.  Also, standard intervention is somewhat more oriented to changing one’s thoughts (I’m a failure; I’ll never be successful; I deserve this pizza) or urges, whereas ABT teaches ways to psychological accept those thoughts and urges such that they no longer determine behavior.

What were the key practices brought to the acceptance group from the ACT, DBT, and RPSA?

These include psychological acceptance of discomfort and loss of pleasure (including the ability to see cravings/urges as waves to be ridden), willingness to choose behaviors even if they bring discomfort or loss of pleasure, clarification of values

How difficult is it to get someone to commit to self-regulation in weight loss?

The initial commitment is often relatively easy.  But sustaining this commitment through time is difficult for a number of reasons, including the fact that weight loss becomes more difficult as time goes by and the rewards become less obvious (e.g. the amount of weight lost per week decreases)

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We know that willpower always fails in diets and resolutions. Does the success of a self-regulation intervention program depend on one’s willpower?

No, the program is built around the idea that willpower is a bogus concept.

Related: The waist-shrinking food found in the produce aisle

Did you find those participants who did not lose weight ‘quickly’ to be less willing/able to depend on their self-direction effort?

We set expectations for moderate and sustainable weight loss of about 2 lbs./week.  Of the people who lose more slowly than this target, some are long-term success stories who embody the “slow-but-steady” idea.  However, many ultimately are not successful.  Thus, overall, success early on is a strong predictor of ultimate success.

Final thought or advice?

Above and beyond everything just discussed, virtually no one is successful in the long-term without (1) a clear set of goals related to lowering energy from food intake and increasing physical activity, (2) a way to track energy intake and physical activity to make sure goals are being met, (3) regular weighing, (4) a structured weight loss program, and (5) accountability from having to report in to someone on a regular and sustained basis.

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Dr. Mark Wiley

By Dr. Mark Wiley

Dr. Mark Wiley is an internationally renowned mind-body health practitioner, author, motivational speaker and teacher. He holds doctorates in both Oriental and alternative medicine, has done research in eight countries and has developed a model of health and wellness grounded in a self-directed, self-cure approach. Dr. Wiley has written 14 books and more than 500 articles. He serves on the Health Advisory Boards of several wellness centers and associations while focusing his attention on helping people achieve healthy and balanced lives through his work with Easy Health Options® and his company, Tambuli Media.