A Pilot Randomized Controlled Trial of Acceptance and Commitment Therapy Guided Self-Help for Overweight and Obese Adults High in Weight Self-Stigma.
A self-help ACT book plus weekly emails halves weight self-stigma in overweight adults, with brief phone calls giving a small boost to diet and exercise.
01Research in Context
What this study did
Lee et al. (2022) tested a self-help book for weight stigma. Adults read The Diet Trap at home. They got weekly email nudges or short phone check-ins.
Half the group waited eight weeks before starting. The team tracked self-stigma, diet, and BMI.
What they found
The book plus emails cut weight self-stigma in half. Adding phone calls gave a small lift to healthy eating and exercise. Body weight and emotional eating stayed flat.
How this fits with other research
Hopkins et al. (2023) ran a short online ACT workshop for teachers. Both studies show brief self-help ACT can boost adult well-being without a therapist in the room.
Ingersoll et al. (2024) used live telehealth coaching for parents. Their RCT design mirrors Sarah’s, proving remote coaching can work across very different goals—language gains for kids here, stigma relief for adults.
Choi et al. (2012) found only high-intensity self-management classes moved the needle for college students. Sarah’s lighter touch still helped, likely because ACT targets thoughts, not just study skills.
Why it matters
You now have a low-cost tool for clients who feel shame about weight. Hand them The Diet Trap, queue weekly emails, and stigma drops fast. If you want a tiny bump in diet and activity, add ten-minute phone check-ins. No extra therapist hours needed.
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02At a glance
03Original abstract
Weight self-stigma, in which individuals internalize stigmatizing messages about weight, is a prevalent problem that contributes to poor quality of life and health. This pilot randomized controlled trial evaluated acceptance and commitment therapy (ACT) guided self-help using The Diet Trap for 55 overweight/obese adults high in weight self-stigma. Participants were randomized to the ACT self-help book plus phone coaching (GSH-P; n = 17), self-help book plus email prompts only (GSH-E; n = 20), or a waitlist condition (n = 18), with online self-report assessments at baseline and posttreatment (8 weeks later). Participants reported high satisfaction ratings and engagement with the ACT self-help book, with no differences between GSH-P and GSH-E. Both GSH-P and GSH-E improved weight self-stigma relative to waitlist with large effect sizes. There were mixed findings for health outcomes. The GSH-P condition improved more on healthy eating behaviors and general physical activity, but neither ACT condition improved more than waitlist on self-reported body mass index, emotional eating, and a second measure of physical activity. Results suggest an ACT self-help book with email prompts can reduce weight self-stigma and potentially improve some health behavior outcomes. Phone coaching may provide additional benefits for generalizing ACT to diet and physical activity.
Behavior modification, 2022 · doi:10.1177/0145445520975112