eating disorders

Bariatric surgery is an effective treatment for obesity. However, around one in five people experience significant weight regain. Acceptance and Commitment Therapy (ACT) teaches acceptance of and defusion from thoughts and feelings which influence behaviour, and commitment to act in line with personal values. To test the feasibility and acceptability of ACT following bariatric surgery a randomised controlled trial of 10 sessions of group ACT or Usual Care Support Group control (SGC) was delivered 15–18 months post bariatric surgery (ISRCTN registry ID: ISRCTN52074801). Participants were compared at baseline, 3, 6 and 12 months using validated questionnaires to assess weight, wellbeing, and healthcare use. A nested, semi-structured interview study was conducted to understand acceptability of the trial and group processes. 80 participants were consented and randomised. Attendance was low for both groups. Only 9 (29%) ACT participants completed > = half of the sessions, this was the case for 13 (35%) SGC participants. Forty-six (57.5%) did not attend the first session. At 12 months, outcome data were available from 19 of the 38 receiving SGC, and from 13 of the 42 receiving ACT. Full datasets were collected for those who remained in the trial. Nine participants from each arm were interviewed. The main barriers to group attendance were travel difficulties and scheduling. Poor initial attendance led to reduced motivation to return. Participants reported a motivation to help others as a reason to join the trial; lack of attendance by peers removed this opportunity and led to further drop out. Participants who attended the ACT groups reported a range of benefits including behaviour change. We conclude that the trial processes were feasible, but that the ACT intervention was not acceptable as delivered. Our data suggest changes to recruitment and intervention delivery that would address this.

Food cravings are a common barrier to losing weight. This article presents a randomised comparison of non-expert group-delivered ultra-brief defusion and acceptance interventions against a distraction control. A total of 63 participants were asked to carry a bag of chocolates for a week while trying to resist the temptation to eat them. A behavioural rebound measure was administered. Each intervention out-performed control in respect of consumption, but not cravings. These techniques may have a place in the clinical management of food cravings. We provide tentative evidence that the mechanism of action is through decreased reactivity to cravings, not through reduced frequency of cravings.

Previous research has emphasized the importance of identifying the core mechanisms underlying eating disorder psychopathology. However, processes that bridge psychological flexibility (PF) and psychological inflexibility (PI) with eating disorder symptoms have yet to be fully clarified, particularly for racially diverse emerging adult women. To address this empirical gap, the current study employed network analysis to explore the interconnections among PF, PI, and eating disorder symptoms in a racially diverse sample of emerging adult women (N = 389). Analyses produced a sparse network, with bridge nodes identified using bridge expected influence (EI). Multiple bridge nodes were identified within the clusters of PI (i.e., lack of awareness), and eating disorder symptoms (i.e., body dissatisfaction). Specifically, results suggested that lack of awareness (PI) and body dissatisfaction (eating disorder symptoms) play essential roles in connecting eating disorder symptoms with PI, even after accounting for PF. In contrast, PF did not appear to be uniquely associated with the deactivation (or activation) of eating disorder symptoms above and beyond PI. These findings contribute to the development of nuanced treatment and prevention models, especially in process-based cognitive behavioral therapy (PB-CBT). Our study also highlights specific processes as primary targets that, when intervened on, could help alleviate eating disorder symptoms, especially for racially diverse emerging adult women.

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Objective
The current study tested the efficacy of an acceptance and commitment therapy (ACT) group intervention for disinhibited eating behaviour as an adjunct to the Veterans Affairs MOVE!© weight management programme.

Methods
Veterans (N = 88) with overweight or obesity who completed the MOVE! weight management programme and self‐identified as having problems with ‘stress‐related eating’ were randomized to four 2‐h weekly ACT sessions or a continued behavioural weight‐loss (BWL) intervention. Assessments were completed at baseline, post‐treatment and 3‐ and 6‐month follow‐up on outcomes of interest including measures of disinhibited eating patterns, obesity‐related quality of life, weight‐related experiential avoidance and weight.

Results
The BWL group exhibited significantly greater reductions in binge eating behaviour at post‐treatment compared with the ACT group. Significant improvements in other outcomes were found with minimal differences between groups. In both groups, decreases in weight‐related experiential avoidance were related to improvements in binge eating behaviour.

Conclusions
Taken together, the continued BWL intervention resulted in larger improvements in binge eating behaviour than the ACT intervention. The two groups showed similar improvements in other disinhibited eating outcomes. Future studies are encouraged to determine if more integrated or longer duration of ACT treatment may maximize eating outcomes in MOVE.

The purpose of this research was to determine the effectiveness of acceptance and commitment therapy on emotional eating of obese women in Isfahan. The research used a quasi-experimental study with a pretest-posttest design and a one month follow up. Through convenience sampling method, 30 women with an obesity diagnosis were selected and then, were randomly assigned into experimental and control groups. All participants completed the Dutch Eating Behaviors Questionnaire (Forman & Herbert, 2009) before intervention, at the end of the intervention and one month after intervention. The intervention involved 8 sessions of acceptance and commitment therapy, each lasting for 90 minutes, which were administered only to the experimental group. Results of covariance analysis showed a significant decrease in the amount of emotional eating in the eating behavior subscale at the post-test, and follow up stages (P<0.05). In the eating desire subscale, there was a significant difference between the mean of experimental group and control group only in the follow up stage (P<0.05). The findings of this study confirmed the efficacy of acceptance and commitment therapy on emotional eating of obese women.

Background
Middle-aged women are at risk of weight gain and associated comorbidities. Deliberate restriction of food intake (dieting) produces short-term weight loss but is largely unsuccessful for long-term weight management. Two promising approaches for the prevention of weight gain are intuitive eating (ie, eating in accordance with hunger and satiety signals) and the development of greater psychological flexibility (ie, the aim of acceptance and commitment therapy [ACT]).

Objectives
This pilot study investigated the usage, acceptability, and feasibility of “Mind, Body, Food,” a Web-based weight gain prevention intervention prototype that teaches intuitive eating and psychological flexibility skills.

Methods
Participants were 40 overweight women (mean age 44.8 [standard deviation, SD, 3.06] years, mean body mass index [BMI] 32.9 [SD 6.01] kg/m2, mean Intuitive Eating Scale [IES-1] total score 53.4 [SD 7.46], classified as below average) who were recruited from the general population in Dunedin, New Zealand. Module completion and study site metrics were assessed using Google Analytics. Use of an online self-monitoring tool was determined by entries saved to a secure online database. Intervention acceptability was assessed postintervention. BMI, intuitive eating, binge eating, psychological flexibility, and general mental and physical health were assessed pre- and postintervention and 3-months postintervention.

Results
Of the 40 women enrolled in the study, 12 (30%) completed all 12 modules (median 7.5 [interquartile range, IQR, 2-12] modules) and 4 (10%) used the self-monitoring tool for all 14 weeks of the intervention period (median 3 [IQR 1-9] weeks). Among 26 women who completed postintervention assessments, most women rated “Mind, Body, Food” as useful (20/26, 77%), easy to use (17/25, 68%) and liked the intervention (22/25, 88%). From pre- to postintervention, there were statistically significant within-group increases in intuitive eating (IES-2 total score P<.001; all IES-2 subscale scores: P ≤.01), psychological flexibility (P=.01), and general mental health (P<.001) as well as significant decreases in binge eating (P=.01). At the 3-month follow-up, IES-2 improvements were maintained, and there were further improvements in binge eating (P<.001) and general mental health (P=.03), and a marginal yet nonsignificant tendency for further improvement in psychological flexibility (P=.06). There were no significant within-group changes in BMI from pre- to postintervention and postintervention to 3-month follow-up (P=.46 and P=.93, respectively).

Conclusions
The “Mind, Body, Food” prototype Web-based intervention is appealing to middle-aged women and may be a useful tool to help women learn intuitive eating and ACT skills, reduce binge eating, and maintain weight over 3 months. Further work to improve the user experience and engagement is required before testing the online intervention in a randomized controlled trial.

Introduction: Obesity is a rapidly growing health problem in every society. The purpose of this study was to determine the effectiveness of acceptance and commitment therapy on
the Body Mass Index (BMI) in women afflicted with obesity in Isfahan. 

Methods: Through a semi-experimental research with pre-test and post-test design with one month follow-up as well as using convenience sampling method, a number of 30 women
with an obesity diagnosis (Body Mass Index, BMI≥30), who were satisfied with the criteria for entering this research, were randomly incorporated into experiment and control groups
(15 each). The intervention involved 8 sessions each lasting for 90 minutes of acceptance and commitment therapy which was provided merely for experiment group. BMI was calculated by dividing weight (kg) by squared height ().

Results: The result of covariance analysis showed that there were no significant differences in body mass index between the experimental and control groups at post-test stage. But results showed a significant decrease in body mass index at follow up stage (p˂ 0.05).

Conclusion: The study showed that acceptance and commitment therapy can lead to reduction in body mass index in follow up stage, in women afflicted with obesity. Therefore,
using this therapeutic approach is recommended for the treatment of obesity.