Lessons Learned from an ACT-Based Physician-Delivered Weight Loss Intervention: A Pilot RCT Demonstrates Limits to Feasibility

Abstract Background: Acceptance and Commitment Therapy (ACT) interventions have shown to be effective in facilitating weight loss for emotional eaters, however, the lack of accessibility of these interventions limits their impact. The present study aimed to increase the accessibility of an ACT intervention for emotional eaters through delivery by physicians. Methods: This two-arm pilot randomized controlled trial tested the effectiveness and feasibility of a brief ACT intervention for emotional eaters compared with standard care at a weight loss clinic in Toronto, Canada. Primary outcomes were changes in weight and emotional eating. Treatment satisfaction was also assessed. Results: Participants in neither condition lost weight. Both conditions displayed decreases in emotional eating, but no condition interaction was found. Both patients and physicians reported high treatment satisfaction with the ACT intervention. However, there were high attrition rates and variability in intervention completion times. Conclusion: The ACT intervention led to reductions in emotional eating and was well received by patients and physicians alike. However, the present study identified high attrition as a limitation to the feasibility of this mode of intervention delivery. Future interventions may be more effectively delivered in primary care settings by encouraging further brevity and exploring delivery by other health professionals. Trial registration: ClinicalTrials.gov NCT03611829. Registered 26 July 2018. Retrospectively registered.