Cited by 148Bariatric Surgery and OutcomesMindfulness and Compassion InterventionsEating Disorders and Behaviors

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Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT

Weineland, Sandra, Arvidsson, Dag, Kakoulidis, Thanos P., Dahl, Joanne·2012·Obesity Research & Clinical Practice

DOI 10.1016/j.orcp.2011.04.004

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Abstract

Summary Bariatric surgery (BS) is rated as the best evidence based treatment for obesity with regard to weight loss and maintenance of weight loss evaluated to date. Although BS interventions are effective, 20-30% of BS patients start to regain weight within 24 months. Emotional eating is a behavior pattern which has been found to predict poor outcome. The aim of this study is to evaluate the effects of acceptance and commitment therapy (ACT) for patients who underwent BS, with regard to emotional eating, body dissatisfaction and quality of life. This study is a randomized controlled trial (n = 39) with two conditions (1) ACT including two face-to-face sessions and support via an Internet application and (2) treatment as usual (TAU) comprising the standard follow-up used by the BS team. Results show that participants in the ACT condition significantly improve on eating disordered behaviors, body dissatisfaction, quality of life and acceptance for weight related thoughts and feelings, as compared to those in the TAU group. This study shows that it is possible to improve effects of BS by specifically targeting emotional eating behavior.:

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BRUXISMO DURANTE O SONO
Nunes, D. T. O., Barros, M. M., Almeida, P. R. C., Lobato, L. S., da Silva, B. M., & Teixeira, R. D. P. (2022) · Amplla Editora eBooks · doi:10.51859/amplla.cco2128-11 · Cited by 16
The ACTyourCHANGE study protocol: promoting a healthy lifestyle in patients with obesity with Acceptance and Commitment Therapy-a randomized controlled trial.
Guerrini Usubini, A., Cattivelli, R., Giusti, E. M., Riboni, F. V., Varallo, G., Pietrabissa, G., Manzoni, G. M., Consoli, S., Bastoni, I., Granese, V., et al. (2021) · Trials · doi:10.1186/s13063-021-05191-y · Cited by 14
A randomised wait-list controlled clinical trial of the effects of acceptance and commitment therapy in patients with type 1 diabetes: a study protocol
Olinder, A. L., Fischier, J., Fries, J., Alfonsson, S., Elvingson, V., Eriksson, J. W., & Leksell, J. K. (2015) · BMC Nursing · doi:10.1186/s12912-015-0101-y · Cited by 15
“Other areas for implementation are also being considered [15] ACT has been tested in numerous behavioural medicine areas such as pain [16], chronic physical diseases [17] and obesity [18, 19], with data showing preliminary good results.”
Background
The Effectiveness of Acceptance and Commitment Therapy on Weight Loss and Cognitive Emotion Regulation in Obese Individuals
Azadeh, Y., Jomehri, F., Seyrafi, M., Mujembari, A. K., & Farsani, G. M. (2019) · doi:10.30699/ijhehp.7.2.192 · Cited by 14
ACTonFOOD: opportunities of ACT to address food addiction
Cattivelli, R., Pietrabissa, G., Ceccarini, M., Spatola, C. A. M., Villa, V., Caretti, A., Gatti, A., Manzoni, G. M., & Castelnuovo, G. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00396 · Cited by 13
“Recent papers deploy in this direction, showing similar effects to traditional CBT at the end of treatment and better long-term outcomes at follow-up (Weineland et al., 2012; Forman et al., 2013).”
Background
Mental Health Support Provided Throughout the Bariatric Surgery Clinical Pathway in French Specialized Care Centers for Obesity
Lamore, K., Kaci, S. S., Czernichow, S., Bretault, M., Bouillot, J., Naudé, A., Gribe-Ouaknine, S., Carette, C., & Flahault, C. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2498-0 · Cited by 13
Lifestyle Modification for the Treatment of Obesity
Sarwer, D. B., Butryn, M. L., Forman, E. M., & Bradley, L. E. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1197-4_15 · Cited by 12
Psychological flexibility, occupational burnout and eating behavior among working women
Nevanperä, N., Lappalainen, R. I., Kuosma, E., Hopsu, L., Uitti, J., & Laitinen, J. H. (2013) · Open Journal of Preventive Medicine · doi:10.4236/ojpm.2013.34048 · Cited by 11
“feelings, and their distress tolerance and psychological flexibility [28,29].”
Acceptance and Commitment Therapy (ACT) for HIV-infected Hazardous Drinkers: A Qualitative Study of Acceptability
Woolf‐King, S. E., Sheinfil, A. Z., Babowitch, J. D., Siedle‐Khan, B., Loitsch, A., & Maisto, S. A. (2018) · Alcoholism Treatment Quarterly · doi:10.1080/07347324.2018.1539630 · Cited by 10
Acceptance and Commitment Therapy for Obesity
Schumacher, L. M., Miller, N. A., Jennings, E. L. M., Chabria, R. S., & Butryn, M. L. (2025) · Current Obesity Reports · doi:10.1007/s13679-025-00634-y · Cited by 11
“On the whole, results were promising [35, 36].”
The effects of using telemedicine for introductory bariatric surgery seminars during the COVID-19 pandemic
Parnell, K. E., Philip, J., Billmeier, S. E., & Trus, T. L. (2022) · Surgical Endoscopy · doi:10.1007/s00464-022-09640-w · Cited by 9
“Increased physical fitness [7], improved weight loss [8, 9], and eating habits [8, 10] as well as overall high patient satisfaction [7, 11–15] have also been reported when incorporating telemedicine into the care for bariatric surgery patients.”
Background
Barriers to and Facilitators of Participation in Weight Loss Intervention for Patients with Suboptimal Weight Loss after Bariatric Surgery: A Qualitative Study among Patients, Physicians, and Therapists
Tettero, O. M., Westerman, M. J., van Stralen, M. M., van den Beuken, M., Monpellier, V. M., Janssen, I. M. C., & Steenhuis, I. H. (2022) · Obesity Facts · doi:10.1159/000526259 · Cited by 9
Internet-based acceptance and commitment therapy for obsessive-compulsive symptoms: A randomized controlled trial
Thompson, E. M., Albertella, L., Viskovich, S., Pakenham, K. I., & Fontenelle, L. F. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104595 · Cited by 8
Psychological Considerations for Bariatric Surgery
Usubini, A. G., Cattivelli, R., Villa, V., Varallo, G., Granese, V., Pietrabissa, G., Manzoni, G. M., Castelnuovo, G., & Molinari, E. (2020) · Bariatric Surgery - From the Non-surgical Approach to the Post-surgery Individual Care [Working Title] · doi:10.5772/intechopen.94450 · Cited by 8
The effectiveness of group psychotherapy based on acceptance and commitment on increasing of mental health and the quality of women's life with breast cancer
Esmali, A., & Alizadeh, M. (2015) · Biosciences Biotechnology Research Asia · doi:10.13005/bbra/1898 · Cited by 7
“If you're offered help, take it”: A qualitative study examining bariatric patients' experience of telephone‐based cognitive behavioural therapy
Santiago, V. A., Cassin, S. E., Wnuk, S., Du, C., Hawa, R., Parikh, S. V., & Sockalingam, S. (2020) · Clinical Obesity · doi:10.1111/cob.12431 · Cited by 7
Psychological inflexibility in terms of eating behaviors among individuals seeking treatment for comorbid affective vulnerabilities and weight-related behaviors
Kauffman, B. Y., Garey, L., & Zvolensky, M. J. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.09.006 · Cited by 8
OBESITY AND COPING STRATEGIES: WHAT IS HIGHLIGHTED BY LITARATURE?
Mensorio›, M. S., & Costa, Á. L. (2016) · Psicologia Saúde & Doenças · doi:10.15309/16psd170313 · Cited by 7
Acceptance and Commitment Therapy for Body Dissatisfaction: A Systematic Review and Meta‐Analysis
Boyle, S., Dorfan, N. M., & Sepehry, A. A. (2025) · Journal of Clinical Psychology · doi:10.1002/jclp.70021 · Cited by 6
Addressing a critical need: A randomised controlled feasibility trial of acceptance and commitment therapy for bariatric surgery patients at 15–18 months post-surgery
Barley, E. A., Bovell, M., Bennett, K., Lee, J. T., Lee‐Baggley, D., Skene, S. S., Tai, M. Z., Brooks, S., & Scholtz, S. (2023) · PLoS ONE · doi:10.1371/journal.pone.0282849 · Cited by 7
The Cyberball task in people after obesity surgery: preliminary evaluation of cognitive effects of social inclusion and exclusion with a laboratory task
Meneguzzo, P., Tenconi, E., Collantoni, E., Longobardi, G., Zappalà, A., Vindigni, V., Favaro, A., & Pavan, C. (2021) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-021-01297-z · Cited by 6
MyGood Trip, a Telemedicine Intervention for Physical Activity Recovery After Bariatric Surgery: Randomized Controlled Trial
Puerto, K. L. I., Bruzzi, M., Rives‐Lange, C., Poghosyan, T., Bretault, M., Châtellier, G., Vilfaillot, A., Chevallier, J., Czernichow, S., & Carette, C. (2022) · JMIR Formative Research · doi:10.2196/26077 · Cited by 7
“Of the completed RCTs, 2 found significant improvements in eating psychopathology using online modules and telephone support [17] and preoperative telephone-based cognitive behavioral therapy [23].”
Background
Weight Loss After Weight-Loss Surgery: The Mediating Role of Dichotomous Thinking
Marshall, C., Reay, R., & Bowman, A. R. (2024) · Obesity Surgery · doi:10.1007/s11695-024-07122-7 · Cited by 5
“For example, through third-wave psychological therapies such as Accept-ance and Commitment Therapy [27–29].”
A latent class analysis of negative emotional eating in bariatric surgery candidates
Dixit, U., Love, A. A., Henderson, R. R., Ahlich, E. M., He, J., Rigby, A., & Zickgraf, H. F. (2025) · Appetite · doi:10.1016/j.appet.2025.107907 · Cited by 5
Transdiagnostic models of eating disorders and therapeutic methods: The example of Fairburn’s cognitive behavior therapy and acceptance and commitment therapy
Dudek, J. E., Ostaszewski, P., & Malicki, S. (2017) · Cited by 5
Predictores psicológicos de la re-ganancia del peso en pacientes bariátricos
Ugarte, C. A., Quiñones, Á., & Vicente, B. (2019) · Terapia psicológica · doi:10.4067/s0718-48082019000300199 · Cited by 5
Eating disorder symptoms and corresponding evidence-based treatments: a narrative review
Ortiz, A. M. L., Peters, A. S., Webber, K. T., Butler, R. M., Fitterman-Harris, H. F., & Levinson, C. (2026) · Journal of Eating Disorders · doi:10.1186/s40337-025-01485-7 · Cited by 5
“Studies have found ACT effective for over-all eating pathology compared to CBT-E [139, 140, 301].”
Acceptance and Commitment Therapy in the Satisfaction of Veterans with Spinal Cord Injuries Spouses
Lashani, L., Farhoudian, A., Azkhosh, M., Dolatshahee, B., & Saadati, H. (2013) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 4
Is Telemedicine as Effective as Face-to-Face Care to Patients with Health Outcomes of Metabolic and Bariatric Surgery? Results from a Systematic Review and Meta-analysis
de Oliveira, G. S., Maia, R. P., Gamba, P. B. B., Figueiredo, A. C. M. G., & de Carvalho, K. M. B. (2025) · Obesity Surgery · doi:10.1007/s11695-025-07792-x · Cited by 3
Taste-Driven Responsiveness to Fat and Sweet Stimuli in Mouse Models of Bariatric Surgery
Dastugue, A., May, C. L., Ledoux, S., Bourgot, C. L., Delaby, P., Bernard, A., & Besnard, P. (2022) · Biomedicines · doi:10.3390/biomedicines10040741 · Cited by 3
Feasibility of Online Cognitive-behavioral Group Therapy Following Metabolic Bariatric Surgery: A Randomized Pilot Study
de Almeida, V. P., Kortchmar, E., Guerra, L. S. D., Neto, F. L., Santo, M. A., & Wang, Y. (2025) · Obesity Surgery · doi:10.1007/s11695-025-08066-2 · Cited by 3
“This pattern is consistent with evidence emphasizing the emotional benefits of group-based cognitive approaches [37, 38].”
Effectiveness of Acceptance and Commitment Therapy on Emotional Eating among Obese Women
Nourian, L., Asghar, A., & Ghorbani, M. (2015) · Cited by 3
Evaluation of multiple interventions using a stepped wedge design
Lyons, V. H., Li, L., Hughes, J. P., & Rowhani‐Rahbar, A. (2017) · Collection of Biostatistics Research Archive · Cited by 3
Modification of the medical exclusion criterion in DSM-5 social anxiety disorder: Comorbid obesity as an example
Dalrymple, K. L., Walsh, E. K., Rosenstein, L. K., Chelminski, I., & Zimmerman, M. A. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.12.055 · Cited by 6
“, 2015), psychological flexibility (Weineland et al., 2012), and body image disturbance (Friedman et al.”
Background
Examination of the relationship between affect, values, and physical activity among cancer survivors
Clemens, K. S., Tull, M. T., Murray, A. B., Boardley, D., Tipton, J. M., & Geers, A. L. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.08.010 · Cited by 4
A Contextual Behavioral Approach for Obesity Surgery Patients
Weineland, S. (2012) · KTH Publication Database DiVA (KTH Royal Institute of Technology) · Cited by 3
Self-citation

Authors: Weineland, S., Arvidsson, D., Kakoulidis, T. P., & Dahl, J.
Affiliations: Uppsala University (SE)
Corresponding author: Weineland, Sandra
ORCID: Weineland, Sandra
Kakoulidis, Thanos P.
Dahl, Joanne
Venue: Obesity Research & Clinical Practice
Publisher: Elsevier BV
Published: 2012-01
Volume: 6
Issue: 1
Pages: e21-e30
ISSN: 1871-403X (ISSN-L)
DOI: 10.1016/j.orcp.2011.04.004
OpenAlex: W2092181171
Cited by: 148
References: 57
Citations by year: 2026: 4 · 2025: 10 · 2024: 4 · 2023: 5 · 2022: 26 · 2021: 12 · 2020: 15 · 2019: 10 · 2018: 15 · 2017: 8 · 2016: 10 · 2015: 12 · 2014: 7 · 2013: 5 · 2012: 5
FWCI: 5.57
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Obesity Research & Clinical Practice (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Keywords: acceptance and commitment therapy, bariatric surgery, obesity, emotional eating, body dissatisfaction, quality of life, weight regain, online psychological intervention, disordered eating

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Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT

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