Acceptance and Commitment Therapy and Weight-Related Difficulties in Overweight and Obese Adults: A Systematic Review

Abstract

Multiple studies have investigated the efficacy of acceptance and commitment therapy (ACT) in improving psychological flexibility among overweight and obese individuals. However, to date, no specific reviews have focused on ACT and weight-related difficulties in this population. This systematic review of the literature aims to identify and assemble all ACT interventions in randomized controlled trials (RCT) that address weight-related difficulties in the treatment of overweight and obese adults. The PRISMA 2020 framework was used for the systematic review, includes manual and computerized database searches. Five databases (Medline, PubMed, Scopus, PsycInfo, and Google) were utilized to gather all articles that: (a) published in English; (b) adopted the RCT design; (c) used ACT as an intervention; (d) included adult participants aged over 18 years with BMI of over 25 kg/m2, and (e) included weight-related difficulties and weight as outcome measures. The review identified seven studies comprising 698 overweight or obese participants of both genders. Improvements were reported in weight-related difficulties and percentage of weight loss in the ACT group and the non-ACT group. The present review supports ACT as an effective intervention that can help adults with weight-related difficulties and excess body weight. Further studies should be conducted in various overweight or obese populations with a more systematic RCT research design to establish the effectiveness of ACT in this area.

The ‘Behavioral Balance Model’: A new perspective on the aetiology and therapy of obesity

“…[47][48][49] Similarly, acceptance and commitment therapy has been found to be very helpful in reducing emotional distress caused by obesity, but is unlikely to bring to and maintain body weight at a lower level. 50,51 Innovative, more tailored approaches such as the recently reported 'regulation of cues intervention', developed based on the behavioural susceptibility theory that might be more effective in a subset of individuals who show a particular high food responsiveness, 52 but it is questionable if such personalized therapies can be provided on a large scale to people with obesity. Innovative neuromodulation techniques such as real-time functional magnetic resonance imaging neurofeedback training 53 or transcranial magnetic stimulation 54,55 that have been shown to affect central nervous processing of food stimuli and to even reduce body weight are quite promising, but either might not be applicable on a large scale.…”

“…While such therapeutic interventions provide important support for treatment‐seeking individuals with obesity by supporting cognitive restraint and reducing emotional eating, alone they rarely can achieve a sufficient long‐term weight reduction 47–49 . Similarly, acceptance and commitment therapy has been found to be very helpful in reducing emotional distress caused by obesity, but is unlikely to bring to and maintain body weight at a lower level 50,51 . Innovative, more tailored approaches such as the recently reported ‘regulation of cues intervention’, developed based on the behavioural susceptibility theory that might be more effective in a subset of individuals who show a particular high food responsiveness, 52 but it is questionable if such personalized therapies can be provided on a large scale to people with obesity.…”