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Acceptance and Commitment Therapy and Eating Disorders

Have you ever heard of Acceptance and Commitment Therapy? Eating disorders are a serious mental health concern affecting millions of people worldwide. Numerous types of therapies are used to help an individual with an eating disorder. One of them is Acceptance Commitment Theory (ACT), which has been seen to both reduce eating disorder behaviors and prevent relapse following primary treatment.

What Is Acceptance Commitment Therapy? 

Acceptance and Commitment Therapy is a type of talk therapy that aims to help people accept difficult emotions and thoughts while making proactive and positive changes in their lives. The concept of ACT is based on the idea that distress is not caused solely by negative thoughts and experiences but rather the fixation on these thoughts and emotions. Rather than something that needs to be “fixed,” in ACT, negative thoughts are presented as part of the greater life experience. Looking at the world in this way has been shown to help create greater psychological flexibility.

Acceptance and Commitment Therapy in Eating Disorder Treatment 

Acceptance and Commitment Therapy has become a widely recommended treatment option for many different eating disorders because of its ability to promote psychological flexibility and acceptance. Acceptance and Commitment Therapy uses 6 major principles to help patients with these perspective shifts. Acceptance, defusion, the observing self, mindfulness, personal values, and committed action. ACT has been seen to help with improving quality of life. This comes from the dual focus of Acceptance and Commitment Therapy, creating greater acceptance of thoughts and feelings and developing new interests to help build a more meaningful life.

Acceptance 

Eating disorders are broadly considered to be coping mechanisms that develop as a way to avoid distressing thoughts, feelings, and physical sensations. Avoidance can occur around food and body-specific internal experiences like consuming specific foods or experiencing body shame. Acceptance and Commitment Therapy emphasizes observing and accepting the full spectrum of thoughts and emotions, making it a natural approach to helping people with eating disorders.

Defusion 

Cognitive fusion is the process in which individuals identify with their thoughts and believe them true. It is common for people with eating disorders to be highly fused with distressing thoughts about themselves. Engaging in behaviors allows these individuals to find self-worth and self-control. Defusion disarms these self-destructive beliefs by assuming that the self is not the content of its thought. Instead, the self is viewed as the one visited by thoughts. Defusion leads the client away from a self-as-content perspective to a self-as-context one.

The Observing Self 

One component of eating disorders that makes them complicated to treat is that the disordered beliefs are closely related to one’s sense of self. Individuals with eating disorders tend to view their eating disorder as part of who they are, and to give it up would cause them to lack identity. Strengthening this sense of self separate from the eating disorder thoughts helps to build a sense of self in which thoughts and feelings related to the eating disorder are not a crucial part of an individual self-conception.

Mindfulness 

Mindfulness refers to active, open attention to the present moment and the ability to observe thoughts and feelings at a distance without judging or owning them. Often, people with eating disorders have difficulty identifying their emotions, making it challenging to defuse them. Mindfulness helps draw attention to these feelings to help process them. 

Personal Values 

Life balance takes a hit when body shape and weight are valued at the expense of other important values. An individual with an eating disorder may avoid family or social activities because they can involve food. While it is often without conscious awareness, body image concerns become extremely overvalued, and other life values lose priority.

Committed Action 

Lacking clarity of one’s values can lead individuals with eating disorders to be unsure about treatment and lack interest in engaging with other areas of life. Acknowledging that core values have been put to the side and recommitting to them can help motivate individuals to fuel all aspects of their recovery.

 

Acceptance and Commitment Therapy: Tying It All Together 

Acceptance and Commitment Therapy has been seen to help treat eating disorders and help individuals sustain their recovery efforts. This is due to the principle of committed action, which gives patients the tools they need to maintain their new perspective and adjust in a healthy way to any changes they may encounter later in life. While some of these concepts can seem strange or difficult initially, with enough practice, they can become second nature and aid someone in their road to recovery. 

BALANCE eating disorder treatment center™, located in New York City, offers free consultation calls to help you explore next steps. We provide in-person programming seven days a week and are in-network with UnitedHealthcare (UHC), Cigna, Emblem, and Oscar, with Aetna coverage coming soon. Support is available, and recovery is possible. Schedule a free consultation call with our admissions team here and stay connected with BALANCE on Instagram here.

References 

Acceptance and commitment therapy. (2023, August 22). Eating Disorder Hope. https://www.eatingdisorderhope.com/treatment-for-eating-disorders/therapies/acceptance commitment-therapy-act 

CET, P. (2016, November 17). Applying ACT to eating disorders: Why it works. Praxis Continuing Education and Training. 

https://www.praxiscet.com/posts/applying-act-eating-disorders-why-it-works/

This post was written by BALANCE Dietetic Intern Stefanie Male (she/her).

Stefanie Mael is a dietetic intern at BALANCE from Long Island, New York. She is working toward receiving her master’s degree in Nutrition and Dietetics at Hunter College and plans to become a REgistered Dietitian after completing her program. Stefanie enjoys baking, cooking, and spending time with friends in her free time. Stefanie is excited to be an intern at BALANCE and learn more about the treatment and impact of eating disorders.

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