The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial
Open accessAbstract
BACKGROUND: Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. METHODS: (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups. RESULTS: Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures. CONCLUSIONS: ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted. TRIAL REGISTRATION: ClinicalTrials.gov ( NCT01738256 ), registered 17 August, 2012.
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Of the four randomized controlled trials, only the study by Ma et al. was blind.
“Although the other four studies [44, 45, 49, 50] were randomized controlled trials, only the study by Ma and colleagues [45] was blind.”
From Mobile Apps for the Management of Comorbid Overweight/Obesity and Depression/Anxiety: A Systematic Review (2020) · cites this paper as [49]
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- Authors
- Järvelä-Reijonen, E., Karhunen, L., Sairanen, E., Muotka, J., Lindroos, S., Laitinen, J., Puttonen, S., Peuhkuri, K., Hallikainen, M., Pihlajamäki, J., Korpela, R., Ermes, M., Lappalainen, R., & Kolehmainen, M.
- Affiliations
- University of Eastern Finland (FI)
- Karlstad University (SE)
- University of Jyväskylä (FI)
- University of Helsinki (FI)
- Finnish Institute of Occupational Health (FI)
- ORCID
- Venue
- International Journal of Behavioral Nutrition and Physical Activity
- Published
- 2018-02-27
- Volume
- 15
- Issue
- 1
- Pages
- 22-22
- ISSN
- 1479-5868 (ISSN-L)
- PMC
- PMC5828146
- OpenAlex
- W2793027590
- Cited by
- 85
- References
- 74
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 7 · 2023: 9 · 2022: 18 · 2021: 12 · 2020: 9 · 2019: 7 · 2018: 1
- FWCI
- 8.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UEF eRepo (University of Eastern Finland) (submittedVersion, cc-by)
- Jyväskylä University Digital Archive (University of Jyväskylä) (submittedVersion, cc-by)
- Digitala vetenskapliga arkivet (Diva) (Karlstad University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Työväentutkimus Vuosikirja (submittedVersion)
- Funders
- Tekes (1104/10)
- The Diabetes Research Foundation, Finland
- Doctoral Programme in Nutrition of the Faculty of Health Sciences, University of Eastern Finland
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- acceptance and commitment therapy, dietary habits, diet quality, mobile health apps, face-to-face intervention, perceived stress, intuitive eating, uncontrolled eating, food as reward, eating competence, food acceptance, food intake regulation, nutrition counseling
- MeSH terms
- Self-Control, Adult, Diet, Eating, Emotions, Feeding Behavior, Female, Finland, Health Education, Humans, Inhibition, Psychological, Male, Middle Aged, Motivation, Obesity, Surveys and Questionnaires, Reward, Body Mass Index, Treatment Outcome, Intuition, Overweight, Mobile Applications, Acceptance and Commitment Therapy
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