A Brief Virtual ACT Workshop for Emotional Eating

Study Overview
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Brief Summary
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Emotional eating is a behaviour that has been linked to weight concerns, mental health concerns, and disordered eating. Effective interventions have been developed to treat emotional eating, however these exist solely in the context of promoting weight loss. Emotional eating is not exclusive to those who struggle with weight and thus interventions are needed that target those who engage in emotional eating regardless of their weight status. The present study aims to do so through the implementation of a brief online Acceptance and Commitment Therapy (ACT) workshop for emotional eaters.

Detailed Description
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Emotional eating is defined as increased food consumption in response to negative emotions, and has been linked to weight concerns, mental health concerns, and disordered eating behaviours. Effective interventions have been developed that address emotional eating, namely to improve weight loss. Such interventions are based in Acceptance and Commitment Therapy (ACT), which encourages tolerance of internal cues, such as emotions, and external cues, such as food. Previous studies have found that brief ACT interventions are effective for the reduction of emotional eating. Our laboratory has recently developed and pilot-tested a one-day ACT workshop intervention for emotional eating, which was found to be effective for reducing emotional eating and deemed feasible and acceptable by participants. The present study was developed with the aim to adapt the above mentioned workshop intervention to an online format in the context of the COVID-19 crisis. The study aims to test the efficacy, feasibility and acceptability of a brief, online version of the above mentioned one-day ACT workshop for emotional eating. The workshops will be delivered through the Zoom online platform.

Official Title
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A Brief Virtual ACT Workshop for Emotional Eating

Conditions
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Emotional Eating, Eating Behavior

Intervention / Treatment
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* Behavioral: Virtual ACT Workshop for Emotional Eating


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Self-identifying as emotional-eater Being over the age of 18 Exclusion Criteria: - N/A

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: All participants will be assigned to the same intervention.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Online ACT workshop for Emotional Eating<br>All participants will be assigned to 2, 1.5 hour interventions using Acceptance and Commitment Therapy (ACT) techniques to help reduce emotional eating. | Behavioral: Virtual ACT Workshop for Emotional Eating<br>* This is a brief online intervention using Acceptance and Commitment Therapy (ACT) technique to target and reduce emotional eating. The intervention will be modeled after Frayn and Knäuper's 1-day ACT workshop for emotional eating intervention, which was derived from Forman and colleagues' Mind Your Health Program. During the workshop, the following topics will be discussed, based on the three processes of ACT: (1) values clarification/commitment, (2) acceptance/distress tolerance, and (3) mindfulness/awareness.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Emotional Eating - Post-Intervention | Emotional eating, as assessed by the Dutch Eating Behaviour Questionnaire Emotional Eating Subscale (DEBQ-EE). Participants are asked to rate the frequency with which they engage in particular eating behaviours, on a 5-point Likert-type rating scale from never (1) to very often (5), with higher scores reflecting higher emotional eating. Only the emotional eating subscale of the DEBQ will be assessed and is calculated by averaging the 13 items that assess emotional eating. | Assessed at post-intervention (1 week following the first session) | 
| Emotional Eating - 2 weeks post-intervention | Emotional eating, as assessed by the Dutch Eating Behaviour Questionnaire Emotional Eating Subscale (DEBQ-EE). Participants are asked to rate the frequency with which they engage in particular eating behaviours, on a 5-point Likert-type rating scale from never (1) to very often (5), with higher scores reflecting higher emotional eating. Only the emotional eating subscale of the DEBQ will be assessed and is calculated by averaging the 13 items that assess emotional eating. | Assessed 2-weeks following the second (last) session | 
| Emotional Eating - 3 months Post-Intervention | Emotional eating, as assessed by the Dutch Eating Behaviour Questionnaire Emotional Eating Subscale (DEBQ-EE). Participants are asked to rate the frequency with which they engage in particular eating behaviours, on a 5-point Likert-type rating scale from never (1) to very often (5), with higher scores reflecting higher emotional eating. Only the emotional eating subscale of the DEBQ will be assessed and is calculated by averaging the 13 items that assess emotional eating. | Assessed 3-months following the second (last) session | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Distress Tolerance - Post-Intervention | Distress tolerance, as assessed by the Distress Tolerance Scale (DTS). Participants are asked to indicate the extent to which they agree with statements aimed at assessing distress tolerance, absorption, appraisal, and regulation from 1 (strongly agree) to 5 (strongly disagree), with lower scores reflecting lower distress tolerance. Subscale scores are derived by calculating the means of the items that make up each subscale. Total score is calculating by averaging the four subscales. | Assessed at post-intervention (1 week following the first session) | 
| Distress Tolerance - 2-weeks Post-Intervention | Distress tolerance, as assessed by the Distress Tolerance Scale (DTS). Participants are asked to indicate the extent to which they agree with statements aimed at assessing distress tolerance, absorption, appraisal, and regulation from 1 (strongly agree) to 5 (strongly disagree), with lower scores reflecting lower distress tolerance. Subscale scores are derived by calculating the means of the items that make up each subscale. Total score is calculating by averaging the four subscales. | Assessed 2-weeks following the second (last) session | 
| Distress Tolerance - 3-months Post-Intervention | Distress tolerance, as assessed by the Distress Tolerance Scale (DTS). Participants are asked to indicate the extent to which they agree with statements aimed at assessing distress tolerance, absorption, appraisal, and regulation from 1 (strongly agree) to 5 (strongly disagree), with lower scores reflecting lower distress tolerance. Subscale scores are derived by calculating the means of the items that make up each subscale. Total score is calculating by averaging the four subscales. | Assessed 3-months following the second (last) session | 
| Food Craving Acceptance and Action - Post-intervention | Food craving acceptance and action, as assessed by the Food Craving Acceptance and Action Questionnaire (FAAQ). Items are rated on a 6-point Likert-type rating scale from 1 (very seldom true) to 6 (always true), with higher scores reflecting higher acceptance. Total score is derived by summing all items. Minimum score is 10 and maximum score is 60. | Assessed at post-intervention (1 week following the first session) | 
| Food Craving Acceptance and Action - 2-weeks Post-intervention | Food craving acceptance and action, as assessed by the Food Craving Acceptance and Action Questionnaire (FAAQ). Items are rated on a 6-point Likert-type rating scale from 1 (very seldom true) to 6 (always true), with higher scores reflecting higher acceptance. Total score is derived by summing all items. Minimum score is 10 and maximum score is 60. | Assessed 2-weeks following the second (last) session | 
| Food Craving Acceptance and Action - 3-months Post-intervention | Food craving acceptance and action, as assessed by the Food Craving Acceptance and Action Questionnaire (FAAQ). Items are rated on a 6-point Likert-type rating scale from 1 (very seldom true) to 6 (always true), with higher scores reflecting higher acceptance. Total score is derived by summing all items. Minimum score is 10 and maximum score is 60. | Assessed 3-months following the second (last) session | 
| Mindful Eating - Post-Intervention | Mindful eating, as assessed by the Mindful Eating Questionnaire (MEQ). It is a 28-item self-report measure that assesses five domains of mindful eating: disinhibition, external cues, awareness, emotional response and distraction. Participants are asked to indicate the extent to which extent they agree with each item from 1 (never / rarely) to 4 (usually/ always), with higher scores reflecting higher levels of mindful eating. Total score is derived by taking the mean of the five subscales. | Assessed at post-intervention (1 week following the first session) | 
| Mindful Eating - 2-weeks Post-Intervention | Mindful eating, as assessed by the Mindful Eating Questionnaire (MEQ). It is a 28-item self-report measure that assesses five domains of mindful eating: disinhibition, external cues, awareness, emotional response and distraction. Participants are asked to indicate the extent to which extent they agree with each item from 1 (never / rarely) to 4 (usually/ always), with higher scores reflecting higher levels of mindful eating. Total score is derived by taking the mean of the five subscales. | Assessed 2-weeks following the second (last) session | 
| Mindful Eating - 3-months Post-Intervention | Mindful eating, as assessed by the Mindful Eating Questionnaire (MEQ). It is a 28-item self-report measure that assesses five domains of mindful eating: disinhibition, external cues, awareness, emotional response and distraction. Participants are asked to indicate the extent to which extent they agree with each item from 1 (never / rarely) to 4 (usually/ always), with higher scores reflecting higher levels of mindful eating. Total score is derived by taking the mean of the five subscales. | Assessed 3-months following the second (last) session | 
| ACT Values Application - Post-intervention | Application of ACT values techniques taught during the workshop, as assessed by items developed by the study's authors. Participants were asked to rate the extent to which they agreed with a number of value-based statements on a scale from 1 (strongly disagree) to 5 (strongly agree). Values score was derived by taking the mean of the items, with higher scores reflecting greater value-consistent eating behaviors. | Assessed at post-intervention (1 week following the first session) | 
| ACT Values Application - 2-weeks Post-intervention | Application of ACT values techniques taught during the workshop, as assessed by items developed by the study's authors. Participants were asked to rate the extent to which they agreed with a number of value-based statements on a scale from 1 (strongly disagree) to 5 (strongly agree). Values score was derived by taking the mean of the items, with higher scores reflecting greater value-consistent eating behaviors. | Assessed 2-weeks following the second (last) session | 
| ACT Values Application - 3-months Post-intervention | Application of ACT values techniques taught during the workshop, as assessed by items developed by the study's authors. Participants were asked to rate the extent to which they agreed with a number of value-based statements on a scale from 1 (strongly disagree) to 5 (strongly agree). Values score was derived by taking the mean of the items, with higher scores reflecting greater value-consistent eating behaviors. | Assessed 3-months following the second (last) session | 
| Emotional Eating Frequency - Post-intervention | As assessed by a self-report item developed by the study's authors. Participants were asked to report the number of times they engaged in emotional eating in the past week. | Assessed at post-intervention (1 week following the first session) | 
| Emotional Eating Frequency - 2-weeks Post-intervention | As assessed by a self-report item developed by the study's authors. Participants were asked to report the number of times they engaged in emotional eating in the past week. | Assessed 2-weeks following the second (last) session | 
| Emotional Eating Frequency - 3-months Post-intervention | As assessed by a self-report item developed by the study's authors. Participants were asked to report the number of times they engaged in emotional eating in the past week. | Assessed 3-months following the second (last) session | 
| Ability to Stop Emotional Eating - Post-intervention | As assessed by a single self-report item developed by the study's authors. Participants were asked to report the number of instances in which they began to engage in emotional eating and were able to stop themselves, on a scale from 1 (none of the time) to 5 (very often). | Assessed at post-intervention (1 week following the first session) | 
| Ability to Stop Emotional Eating - 2-weeks Post-intervention | As assessed by a single self-report item developed by the study's authors. Participants were asked to report the number of instances in which they began to engage in emotional eating and were able to stop themselves, on a scale from 1 (none of the time) to 5 (very often). | Assessed 2-weeks following the second (last) session | 
| Ability to Stop Emotional Eating - 3-months Post-intervention | As assessed by a single self-report item developed by the study's authors. Participants were asked to report the number of instances in which they began to engage in emotional eating and were able to stop themselves, on a scale from 1 (none of the time) to 5 (very often). | Assessed 3-months following the second (last) session | 
| Feasibility Data: Recruitment Rates | Overall number of participants who expressed interest in the workshop over the recruitment period. | Assessed during the recruitment period (i.e. over a period of 2 months) | 
| Feasibility Data: Workshop Attendance Rates | Number of participants who received the intervention (i.e. who attended both workshop sessions) out of the number of participants who signed up. | Assessed during the treatment period: from baseline to post-treatment (i.e. over the course of 1 week). | 
| Feasibility Data: Dropout Rates | Number of participants who have dropped out or withdrawn from the study at any time point from baseline assessment to last follow-up assessment. Number of dropouts and withdrawals will be kept track of at each study time-point. | Assessed from baseline to the 3-month follow-up assessment. | 
| Feasibility Data: Loss-to-Follow-Up Rates | Number of participants (out of those who have attended the workshop) who have not completed the follow-up questionnaire(s). The number of participants with missing follow-up data will be kept track of at all follow-up time points (post-treatment, 2-week follow-up, and 3-month follow-up). | Assessed at the 2-week follow-up time point and the 3-month follow-up time point. |