Psychological flexibility mediates change in intuitive eating regulation in acceptance and commitment therapy interventions

Essi Sairanen, Asko Tolvanen, Leila Karhunen, Marjukka Kolehmainen, Elina Järvelä-Reijonen, Sanni Lindroos, Katri Peuhkuri, Riitta Korpela, Miikka Ermes, Elina M. Mattila, Raimo Lappalainen

    Research output: Contribution to journalArticleScientificpeer-review

    29 Citations (Scopus)


    Objective: Despite the promising results related to intuitive eating, few studies have attempted to explain the processes encouraging this adaptive eating behaviour. The focus of the present study was on exploring mechanisms of change in intuitive eating and weight in acceptance and commitment therapy (ACT) interventions. Mediation provides important information regarding the treatment processes and theoretical models related to specific treatment approaches. The study investigates whether psychological flexibility, mindfulness skills and sense of coherence mediated the interventions' effect on intuitive eating and weight. Design: Secondary analysis of a randomized control trial. Mediation analysis compared two ACT interventions - face-to-face (in a group) and mobile (individually) - with a control group using a latent difference score model. Settings: Data were collected in three Finnish towns. Subjects: The participants were overweight or obese (n 219), reporting symptoms of perceived stress. Results: The effect of the interventions on participants' (i) BMI, (ii) intuitive eating and its subscales, (iii) eating for physical rather than emotional reasons and (iv) reliance on internal hunger and satiety cues was mediated by changes in weight-related psychological flexibility in both ACT groups. Conclusions: These findings suggest that ACT interventions aiming for lifestyle changes mediate the intervention effects through the enhanced ability to continue with valued activities even when confronted with negative emotions and thoughts related to weight.
    Original languageEnglish
    Pages (from-to)1681-1691
    JournalPublic Health Nutrition
    Issue number9
    Publication statusPublished - 1 Jun 2017
    MoE publication typeA1 Journal article-refereed


    • acceptance and commitment therapy overweight
    • intuitive eating
    • psychological flexibility
    • Psychological flexibility
    • Acceptance and commitment therapy Overweight
    • Intuitive eating
    • Acceptance and Commitment Therapy
    • Overweight/psychology
    • Life Style
    • Body Weight
    • Follow-Up Studies
    • Humans
    • Middle Aged
    • Male
    • Hunger
    • Appetite Regulation
    • Adult
    • Female
    • Surveys and Questionnaires
    • Eating/psychology
    • Body Mass Index
    • Cues
    • Health Behavior
    • Emotions
    • Obesity/psychology
    • Satiation
    • Health Education


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