Acceptance and commitment therapy, referred as ACT, is used widely to promote healthy lifestyles and psychological well-being in many contexts, including addictions, cardiovascular diseases, and eating disorders Prevedini et al. For example ACT-based intervention was used with promising results to improve exercise tolerance in low-active women Ivanova et al. The psychological flexibility model, grounded in functional contextualism and directly derived from the relational frame theory, which is a behavioral account of language and cognition, faces the challenge of the human condition to promote better adaptation to different life-contexts.
The clinical application of this model is a technology, ACT, that is under continuous revision and is marked by a high level of flexibility, a range of clinical and sub-clinical applications, and a strong link to basic science Gifford and Lillis, ; Barnes and Tantleff-Dunn, a. ACT, established in behavioral technologies and sciences, can integrate gold standard practices to improve compliance, foster behavior modification, and promote the continuous monitoring of target behaviors.
Furthermore, functional, and not merely topographical, adaptations of ACT are needed to nurture behavioral change to account for the sociocultural diversity of different contexts and improve effectiveness of interventions for different contexts Cattivelli et al. The focus of acceptance and mindfulness-based treatments is to increase flexibility, not through the replacement of dysfunctional thoughts or the introduction of powerful control strategies e.
New Weight-Loss Treatment Helps You Diet Despite Feeling Tired & Hungry | Live Science
Teaching acceptance and mindfulness skills to handle difficult feelings and thoughts may be particularly helpful for those who are inflexible and who tend to avoid emotional distress Lillis et al. ACT offers a range of valid applications for obesity and weight-management, from individual therapy to group settings, with both in- and outpatients. Further, ACT offers different ways to provide treatments, including phone consultation and web-based interventions, with highly efficient resource allocation, valuable outcomes, and efficiency.
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Recent findings show excellent results in this area Bricker et al. The opportunity to introduce ACT web-based protocols to target obesity is probably a valid innovation in the range of treatments for overweight regarding cost-resources efficiency. Recent literature on smoke cessation using an ACT approach has yielded important outcomes and innovations in content delivery Schuck et al.
ACT ON HEALTH: An ACT group programme for weight management
The adaptation of content to be freely shareable and flexible in the maintenance phase after a specific program or stand-alone treatment could be a significant innovation in weight control science and could reach different populations to increase the social influence of acceptance-based programs in health promotion.
Changing the focus from topography to function, without directly aiming focusing on psychological distress but addressing the disposition to control or avoid difficult emotions and thoughts, is the key feature of ACT. ACT may be relevant to treating overweight and obesity because of the long-term weakness of more traditional approaches Prevedini et al. This idea is consistent with the literature on addictions and substance abuse, which suggest that a fundamental way to maintain abstinence is to increase the individual's openness to psychological struggles or triggers; the pain literature shows similar findings Gifford and Lillis, ; Lillis et al.
Therefore, treatments for obese individuals with high FA levels should include teaching a greater tolerance of psychological distress, increasing the ability to engage in value-oriented actions, and reducing the struggle to control difficult emotions and thoughts and develop better management of emotional eating, thus fostering long-term behavioral change. Forman et al.
These preliminary findings support the introduction of acceptance and mindfulness-based interventions in the context of traditional multi-disciplinary interventions for obesity, especially when targeting non-respondent and highly-avoidant individuals Forman et al. An explicit inclusion of FA and experiential avoidance measures, in particular for non-responders to standard treatments, could represent a first step to tailored interventions for individuals presenting high levels of avoidant and addiction-like behaviors.
Thus, the inclusion of ACT in well-established multi-disciplinary intervention to replace or use in combination with CBT may foster behavioral changes that are consistent with health habits, particularly for highly avoidant patients Lillis et al. The added value of acceptance and mindfulness-based treatments is not a short-term change; rather, it yields long lasting outcomes.
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. The identification of psychological factors, in particular FA, may help select individuals who require an intervention aimed to reduce experiential avoidance and promote value-base acting, thus, allowing an increase in the effectiveness and efficiency of existing treatments in combination with ACT. There is no clear consensus on the existence of well-defined criteria neither for FA nor, as pointed out by recent literature Hebebrand et al.
Nonetheless, DSM5 seems to open to broader definitions of addictive behaviors, including non-substance related disorders Hone-Blanchet and Fecteau, ; Meule and Gearhardt, ; Potenza, Thus, the debate is still open, as recent guidelines from Australian PA Hay et al. Despite this, promising results in the field of obesity associated with addiction-like behaviors toward food Forman et al.
Hopefully, in the near future research will identify key elements of addiction recurring in the field of addictive eating and food dysfunctional consumption, and design interventions more tailored to face them.
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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. A-Tjak, J. A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Avena, N. Drug Abuse Rev. Tossing the baby out with the bathwater after a brief rinse?
Background
The potential downside of dismissing food addiction based on limited data. Further developments in the neurobiology of food and addiction: update on the state of the science. Nutrition 28, — Barnes, R. A preliminary investigation of sex differences and the mediational role of food thought suppression in the relationship between stress and weight cycling. Weight Disord. Food for thought: examining the relationship between food thought suppression and weight-related outcomes.
Boggiano, M. Motives for eating tasty foods associated with binge-eating. Results from a student and a weight-loss seeking population. Appetite 83C, — Bricker, J. Pilot randomized controlled trial of web-based acceptance and commitment therapy for smoking cessation. Nicotine Tob Res. Byrne, S. Weight maintenance and relapse in obesity: a qualitative study. Psychological predictors of weight regain in obesity.
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Trials Ebesity - e-health for obesity - new technologies for the treatment of obesity in clinical psychology and medicine. Health 7, 5—8. Cattivelli, R. Prospettive educative attraverso un approccio clinico: i contributi dell'Acceptance and commitment therapy e della functional analytic psychotherapy nel caso di un ragazzo con ansia sociale.
Psicoterapia Cognitivo Comportamentale Google Scholar. Promoting appropriate behavior in daily life contexts using functional analytic psychotherapy in early-adolescent children. Cawley, J. Savings in medical expenditures associated with reductions in body mass index among US adults with obesity, by diabetes status.
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New Therapy Helps You Lose Weight Despite Feeling Tired & Hungry
Virtual reality for enhancing the cognitive behavioral treatment of obesity with binge eating disorder: randomized controlled study with one-year follow-up. The Acceptance Based Treatment lost This is among the largest ever success in behavioural treatment for weight loss without using an aggressive diet regime or medications most of which have multiple harmful effects and short lasting results.
What is different about Acceptance Based Treatment? It teaches you accept physical discomfort, such as hunger and craving, without needing to get rid of it with food. It also teaches you to accept the reduction in pleasure associated with eating. So rather than a battle between you and your urges, you learn to notice them come and go. And it teaches you to connect to the values that are important to you about losing weight , rather than just focussing on the goal of losing weight in and of itself.