Acceptance and commitment therapy (ACT) for eating disorders: A systematic review of intervention studies and call to action

Abstract

Acceptance and Commitment Therapy (ACT) is increasingly used to treat eating disorders (EDs); however, the evidence for ACT with EDs has not been the subject of a systematic review. The current study reviews the evidence of ACT for EDs through January of 2022. PubMed and PsycInfo were searched for treatment studies using three or more ACT processes with adolescents or adults with anorexia nervosa, bulimia nervosa, binge eating disorder and purging disorder spectrum diagnoses. Studies focusing primarily on obesity, weight loss or body image were excluded. Twenty-two intervention studies were identified with a combined total of 674 participants. Five were randomized controlled trials. While the majority of studies focused on anorexia nervosa, these tended to be smaller studies of fewer participants. Results indicated that ACT may show reasonable efficacy for improvements in ED symptoms. However, most studies lacked sufficient methodological rigor and were weak on two or more components of the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Future directions and limitations of using the EPHPP for quality assessment of psychological interventions are discussed, as well as strengths and weaknesses of the evidence base in light of the recent ACBS Task Force Report on the Strategies and Tactics of Contextual Behavioral Science Research.