Regulating Eating through Acceptance and Commitment Therapy (REACT): a single case experimental design to evaluate a guided self-help intervention for individuals who are overweight or obese and engage in emotional eating
Creators: name: Jinks, Mary
Publisher: name: University of Lincoln
Year: 2024
Subjects: C840 - Psychology in health &amp; medicine

description: Background: Obesity rates are growing globally along with the associatedhealth and economic consequences (Caballero, 2007). However, weight loss isdifficult, highlighting the need to address the psychological challenges of obesity(Wing &amp; Phelan, 2005). Obesity is linked with emotional eating (Torres &amp;Nowson, 2007). Therefore, interventions which may tackle emotional eatingmay address obesity. This study evaluated the effectiveness of an Acceptanceand Commitment Therapy (ACT; Hayes, Strosahl &amp; Wilson, 1999) interventionwhich has been considered helpful for this clinical problem.Method: Six participants engaged in a five week guided self-help ACTintervention. Utilising an AB single case experimental design (SCED) andfollow-up, participants completed a range of implicit, explicit and behaviouralassessments; targeting areas such as emotional eating, psychological ACTprocesses (referred to hereafter as ACT processes), Body Mass Index (BMI),and daily recordings of calorie intake and mood. Reliable and clinicallysignificant changes were calculated on self-report measures. SimulationModelling Analysis (SMA) examined the relationship between mood and calorieintake across baseline and intervention phases.Results: Half of the sample no longer met the criteria for “emotional eating” atfollow-up. On the self-report measures, all participants “recovered”1 on at leastone ACT-specific process, whilst two participants “recovered” from emotionaleating. There was some evidence of temporal precedence whereby changes inthe ACT processes occurred, prior to, or alongside, changes in emotionaleating. SMA revealed a decrease in emotional eating in the intervention phasecompared to the baseline phase for some participants. Inconsistencies werefound between the implicit and explicit measures of emotional eating. Postintervention,four participants lost weight, three of whom maintained the weightloss at follow-up. All participants reported benefits from ACT.Discussion: Given the current obesity epidemic and the associated adverseconsequences, finding an effective intervention for weight management iscritical. This study resulted in four important findings; (a) ACT proved promisingfor some participants in reducing emotional eating and shifted the ACT process1 Achieved both reliable and clinically significant change (Davies &amp; Sheldon, 2011).3variables in a positive direction; (b) There was some evidence that ACTprocesses mediated changes in emotional eating. This has important theoreticalimplications as it indicates that mindfulness, defusion, values and acceptanceinfluence emotional eating. Although theories have hypothesised this to be thecase, this study provides empirical support. However, more single caseresearch is required to demonstrate the replication of effect prior to refiningweight management interventions; (c) Improvements in emotional eatingmeasures did not reduce weight in all cases. This suggests that ACT alone, orin its current modality, may not be sufficient for behavioural change. It issuggested that more intensive input may be needed, or that ACT may make auseful adjunct to standard behavioural interventions. Nevertheless, in terms ofcost-effectiveness, the brevity and modality of this intervention is a promisingstart, and (d) There were mixed findings regarding the impact of the interventionon the implicit emotional eating measure; correspondence with the explicitmeasure occurred for some participants. The utility of implicit measurement intargeting attitudes, behaviour or initial responses in this sample is questionable.