A One-Day 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 one day 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. Emotional eating, however, is not exclusive to those who struggle with their weight. Many individuals maintain a normal weight despite engaging in emotional eating. These individuals still consume an excess of high calorie (for which they somehow eventually compensate), high fat, and high sugar foods as part of their emotional eating. Unhealthy dietary habits such as these have been shown to be associated with an increased risk of all-cause mortality, as well as health concerns including diabetes and cardiovascular disease. Individuals with normal weight are not eligible for ACT programs described above, despite the increased risk of health concerns associated with emotional eating. The present study aims to test the feasibility and acceptability of a one-day ACT workshop to reduce emotional eating and improve health that is not focused on weight loss as its primary outcome, and rather targets all individuals who engage in emotional eating.

Official Title
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A One-Day ACT Workshop for Emotional Eating

Conditions
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Emotional Eating, Eating Behavior

Intervention / Treatment
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* Behavioral: ACT Workshop for Emotional Eating


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Engaging in emotional eating as per a DEBQ-EE score of 3.25 or higher Being over the age of 18 Exclusion Criteria: Not meeting the DEBQ-EE 3.25 or higher inclusion criteria Being under the age of 18

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: ACT Workshop for Emotional Eating<br>All participants will be assigned to a one-day intervention using Acceptance and Commitment Therapy (ACT) techniques to help reduce emotional eating. | Behavioral: ACT Workshop for Emotional Eating<br>* This is a one-day intervention using Acceptance and Commitment Therapy (ACT) technique to target and reduce emotional eating. The intervention will be modeled after Frayn and Knäuper's (2016) brief emotional eating intervention, which was derived from Forman et al.'s (2013) 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 - 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| 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 from baseline to 2-weeks post-intervention and 3-months post-intervention | 
| Feasibility Data: Recruitment, Eligibility, Attendance, and Attrition Rates | These include recruitment, eligibility, attendance, and attrition rates | Assessed throughout the duration of the study from the recruitment period to the completion of the workshops and follow-up questionnaires (i.e., over a 3-month period). |