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

Elina Järvelä-Reijonen (Corresponding Author), Leila Karhunen, Essi Sairanen, Joona Muotka, Sanni Lindroos, Jaana Laitinen, Sampsa Puttonen, Katri Peuhkuri, Maarit Hallikainen, Jussi Pihlajamäki, Riitta Korpela, Miikka Ermes, Raimo Lappalainen, Marjukka Kolehmainen

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    8 Citations (Scopus)

    Abstract

    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: Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants' (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (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.

    Original languageEnglish
    Article number22
    JournalInternational Journal of Behavioral Nutrition and Physical Activity
    Volume15
    Issue number1
    DOIs
    Publication statusPublished - 27 Feb 2018
    MoE publication typeA1 Journal article-refereed

    Fingerprint

    Acceptance and Commitment Therapy
    Mobile Applications
    Feeding Behavior
    Randomized Controlled Trials
    Diet
    Eating
    Attitude to Health
    Psychology
    Food
    Reward
    Alcohol Drinking
    Mental Competency
    Motivation
    Counseling
    Body Mass Index
    Obesity

    Keywords

    • ACT
    • Behavior change
    • Dietary intake
    • Intuitive eating
    • MHealth
    • Mindful eating
    • Mindfulness
    • Obesity
    • Overweight
    • Regulation of eating behavior

    Cite this

    Järvelä-Reijonen, Elina ; Karhunen, Leila ; Sairanen, Essi ; Muotka, Joona ; Lindroos, Sanni ; Laitinen, Jaana ; Puttonen, Sampsa ; Peuhkuri, Katri ; Hallikainen, Maarit ; Pihlajamäki, Jussi ; Korpela, Riitta ; Ermes, Miikka ; Lappalainen, Raimo ; Kolehmainen, Marjukka. / 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. In: International Journal of Behavioral Nutrition and Physical Activity. 2018 ; Vol. 15, No. 1.
    @article{475e2ebd18f6475ca41d50a4e2adef22,
    title = "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",
    abstract = "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: Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants' (n = 219, 85{\%} females) mean body mass index was 31.3 kg/m2 (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.",
    keywords = "ACT, Behavior change, Dietary intake, Intuitive eating, MHealth, Mindful eating, Mindfulness, Obesity, Overweight, Regulation of eating behavior",
    author = "Elina J{\"a}rvel{\"a}-Reijonen and Leila Karhunen and Essi Sairanen and Joona Muotka and Sanni Lindroos and Jaana Laitinen and Sampsa Puttonen and Katri Peuhkuri and Maarit Hallikainen and Jussi Pihlajam{\"a}ki and Riitta Korpela and Miikka Ermes and Raimo Lappalainen and Marjukka Kolehmainen",
    year = "2018",
    month = "2",
    day = "27",
    doi = "10.1186/s12966-018-0654-8",
    language = "English",
    volume = "15",
    journal = "International Journal of Behavioral Nutrition and Physical Activity",
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    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 2018, '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', International Journal of Behavioral Nutrition and Physical Activity, vol. 15, no. 1, 22. https://doi.org/10.1186/s12966-018-0654-8

    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. / Järvelä-Reijonen, Elina (Corresponding Author); Karhunen, Leila; Sairanen, Essi; Muotka, Joona; Lindroos, Sanni; Laitinen, Jaana; Puttonen, Sampsa; Peuhkuri, Katri; Hallikainen, Maarit; Pihlajamäki, Jussi; Korpela, Riitta; Ermes, Miikka; Lappalainen, Raimo; Kolehmainen, Marjukka.

    In: International Journal of Behavioral Nutrition and Physical Activity, Vol. 15, No. 1, 22, 27.02.2018.

    Research output: Contribution to journalArticleScientificpeer-review

    TY - JOUR

    T1 - The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app

    T2 - A randomized controlled trial

    AU - Järvelä-Reijonen, Elina

    AU - Karhunen, Leila

    AU - Sairanen, Essi

    AU - Muotka, Joona

    AU - Lindroos, Sanni

    AU - Laitinen, Jaana

    AU - Puttonen, Sampsa

    AU - Peuhkuri, Katri

    AU - Hallikainen, Maarit

    AU - Pihlajamäki, Jussi

    AU - Korpela, Riitta

    AU - Ermes, Miikka

    AU - Lappalainen, Raimo

    AU - Kolehmainen, Marjukka

    PY - 2018/2/27

    Y1 - 2018/2/27

    N2 - 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: Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants' (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (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.

    AB - 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: Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants' (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (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.

    KW - ACT

    KW - Behavior change

    KW - Dietary intake

    KW - Intuitive eating

    KW - MHealth

    KW - Mindful eating

    KW - Mindfulness

    KW - Obesity

    KW - Overweight

    KW - Regulation of eating behavior

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    U2 - 10.1186/s12966-018-0654-8

    DO - 10.1186/s12966-018-0654-8

    M3 - Article

    AN - SCOPUS:85042546791

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    JO - International Journal of Behavioral Nutrition and Physical Activity

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