Eating Behavior, Emotional Eating
Conditions
Brief summary
Emotional eating is a behaviour that has been linked to weight concerns, mental health concerns, and disordered eating. Effective interventions have been developed to treat emotional eating, however these exist solely in the context of promoting weight loss. Emotional eating is not exclusive to those who struggle with weight and thus interventions are needed that target those who engage in emotional eating regardless of their weight status. The present study aims to do so through the implementation of a one day Acceptance and Commitment Therapy (ACT) workshop for emotional eaters.
Detailed description
Emotional eating is defined as increased food consumption in response to negative emotions, and has been linked to weight concerns, mental health concerns, and disordered eating behaviours. Effective interventions have been developed that address emotional eating, namely to improve weight loss. Such interventions are based in Acceptance and Commitment Therapy (ACT), which encourages tolerance of internal cues, such as emotions, and external cues, such as food. Emotional eating, however, is not exclusive to those who struggle with their weight. Many individuals maintain a normal weight despite engaging in emotional eating. These individuals still consume an excess of high calorie (for which they somehow eventually compensate), high fat, and high sugar foods as part of their emotional eating. Unhealthy dietary habits such as these have been shown to be associated with an increased risk of all-cause mortality, as well as health concerns including diabetes and cardiovascular disease. Individuals with normal weight are not eligible for ACT programs described above, despite the increased risk of health concerns associated with emotional eating. The present study aims to test the feasibility and acceptability of a one-day ACT workshop to reduce emotional eating and improve health that is not focused on weight loss as its primary outcome, and rather targets all individuals who engage in emotional eating.
Interventions
BEHAVIORALACT Workshop for Emotional Eating
This is a one-day intervention using Acceptance and Commitment Therapy (ACT) technique to target and reduce emotional eating. The intervention will be modeled after Frayn and Knäuper's (2016) brief emotional eating intervention, which was derived from Forman et al.'s (2013) Mind Your Health program. During the workshop, the following topics will be discussed, based on the three processes of ACT: (1) values clarification/commitment, (2) acceptance/distress tolerance, and (3) mindfulness/awareness.
Sponsors
McGill University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
All participants will be assigned to the same intervention.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Engaging in emotional eating as per a DEBQ-EE score of 3.25 or higher * Being over the age of 18
Exclusion criteria
* Not meeting the DEBQ-EE 3.25 or higher inclusion criteria * Being under the age of 18
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Emotional Eating - 2-weeks Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | Emotional eating, as assessed by the Dutch Eating Behaviour Questionnaire Emotional Eating Subscale (DEBQ-EE). Participants are asked to rate the frequency with which they engage in particular eating behaviours, on a 5-point Likert-type rating scale from never (1) to very often (5), with higher scores reflecting higher emotional eating. Only the emotional eating subscale of the DEBQ will be assessed and is calculated by averaging the 13 items that assess emotional eating. |
| Emotional Eating - 3-months Post-Intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | Emotional eating, as assessed by the Dutch Eating Behaviour Questionnaire Emotional Eating Subscale (DEBQ-EE). Participants are asked to rate the frequency with which they engage in particular eating behaviours, on a 5-point Likert-type rating scale from never (1) to very often (5), with higher scores reflecting higher emotional eating. Only the emotional eating subscale of the DEBQ will be assessed and is calculated by averaging the 13 items that assess emotional eating. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Food Craving Acceptance and Action - 2-weeks Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | Food craving acceptance and action, as assessed by the Food Craving Acceptance and Action Questionnaire (FAAQ). Items are rated on a 6-point Likert-type rating scale from 1 (very seldom true) to 6 (always true), with higher scores reflecting higher acceptance. Total score is derived by summing all items. Minimum score is 10 and maximum score is 60. |
| Food Craving Acceptance and Action - 3-months Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | Food craving acceptance and action, as assessed by the Food Craving Acceptance and Action Questionnaire (FAAQ). Items are rated on a 6-point Likert-type rating scale from 1 (very seldom true) to 6 (always true), with higher scores reflecting higher acceptance. Total score is derived by summing all items. Minimum score is 10 and maximum score is 60. |
| Mindful Eating - 2-weeks Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | Mindful eating, as assessed by the Mindful Eating Questionnaire (MEQ). It is a 28-item self-report measure that assesses five domains of mindful eating: disinhibition, external cues, awareness, emotional response and distraction. Participants are asked to indicate the extent to which extent they agree with each item from 1 (never / rarely) to 4 (usually/ always), with higher scores reflecting higher levels of mindful eating. Total score is derived by taking the mean of the five subscales. |
| Mindful Eating - 3-months Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | Mindful eating, as assessed by the Mindful Eating Questionnaire (MEQ). It is a 28-item self-report measure that assesses five domains of mindful eating: disinhibition, external cues, awareness, emotional response and distraction. Participants are asked to indicate the extent to which extent they agree with each item from 1 (never / rarely) to 4 (usually/ always), with higher scores reflecting higher levels of mindful eating. Total score is derived by taking the mean of the five subscales. |
| ACT Values Application - 2-weeks Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | Application of ACT values techniques taught during the workshop, as assessed by items developed by the study's authors. Participants were asked to rate the extent to which they agreed with a number of value-based statements on a scale from 1 (strongly disagree) to 5 (strongly agree). Values score was derived by taking the mean of the items, with higher scores reflecting greater value-consistent eating behaviors. |
| Distress Tolerance - 2-weeks Post-Intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | Distress tolerance, as assessed by the Distress Tolerance Scale (DTS). Participants are asked to indicate the extent to which they agree with statements aimed at assessing distress tolerance, absorption, appraisal, and regulation from 1 (strongly agree) to 5 (strongly disagree), with lower scores reflecting lower distress tolerance. Subscale scores are derived by calculating the means of the items that make up each subscale. Total score is calculating by averaging the four subscales. |
| Emotional Eating Frequency - 2-weeks Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | As assessed by a self-report item developed by the study's authors. Participants were asked to report the number of times they engaged in emotional eating in the past week. |
| Emotional Eating Frequency - 3-months Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | As assessed by a self-report item developed by the study's authors. Participants were asked to report the number of times they engaged in emotional eating in the past week. |
| Ability to Stop Emotional Eating - 2-weeks Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | As assessed by a single self-report item developed by the study's authors. Participants were asked to report the number of instances in which they began to engage in emotional eating and were able to stop themselves, on a scale from 1 (none of the time) to 5 (very often). |
| Ability to Stop Emotional Eating - 3-months Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | As assessed by a single self-report item developed by the study's authors. Participants were asked to report the number of instances in which they began to engage in emotional eating and were able to stop themselves, on a scale from 1 (none of the time) to 5 (very often). |
| Feasibility Data: Recruitment, Eligibility, Attendance, and Attrition Rates | Assessed throughout the duration of the study from the recruitment period to the completion of the workshops and follow-up questionnaires (i.e., over a 3-month period). | These include recruitment, eligibility, attendance, and attrition rates |
| ACT Values Application - 3-months Post-intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | Application of ACT values techniques taught during the workshop, as assessed by items developed by the study's authors. Participants were asked to rate the extent to which they agreed with a number of value-based statements on a scale from 1 (strongly disagree) to 5 (strongly agree). Values score was derived by taking the mean of the items, with higher scores reflecting greater value-consistent eating behaviors. |
| Distress Tolerance - 3-months Post-Intervention | Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention | Distress tolerance, as assessed by the Distress Tolerance Scale (DTS). Participants are asked to indicate the extent to which they agree with statements aimed at assessing distress tolerance, absorption, appraisal, and regulation from 1 (strongly agree) to 5 (strongly disagree), with lower scores reflecting lower distress tolerance. Subscale scores are derived by calculating the means of the items that make up each subscale. Total score is calculating by averaging the four subscales. |
Countries
Canada
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| ACT Workshop for Emotional Eating All participants were assigned to an ACT workshop designed to reduce emotional eating through the teaching of three skills: (1) values clarification/commitment, (2) acceptance/distress tolerance, and (3) mindfulness. | 32 |
| Total | 32 |
Baseline characteristics
| Characteristic | ACT Workshop for Emotional Eating |
|---|---|
| Ability to stop emotional eating | 1.96 units on a scale STANDARD_DEVIATION 0.88 |
| ACT Values Application | 3.24 units on a scale STANDARD_DEVIATION 0.66 |
| Age, Continuous | 46.71 years STANDARD_DEVIATION 13.43 |
| Distress Tolerance Scale | 3.32 units on a scale STANDARD_DEVIATION 0.92 |
| Dutching Eating Behavior Questionnaire-emotional eating | 3.91 units on a scale STANDARD_DEVIATION 0.46 |
| Emotional eating frequency | 4.64 times per week STANDARD_DEVIATION 1.66 |
| Food Craving Acceptance and Action Questionnaire | 28.18 units on a scale STANDARD_DEVIATION 6.24 |
| Mindful Eating Questionnaire | 2.35 units on a scale STANDARD_DEVIATION 0.35 |
| Race/Ethnicity, Customized Ethnic group Black | 1 Participants |
| Race/Ethnicity, Customized Ethnic group Caucasian | 25 Participants |
| Race/Ethnicity, Customized Ethnic group Hispanic | 1 Participants |
| Race/Ethnicity, Customized Ethnic group Middle Eastern | 1 Participants |
| Race/Ethnicity, Customized Ethnic group Other | 4 Participants |
| Region of Enrollment Canada | 32 participants |
| Sex: Female, Male Female | 28 Participants |
| Sex: Female, Male Male | 4 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 32 |
| other Total, other adverse events | 0 / 32 |
| serious Total, serious adverse events | 0 / 32 |
Outcome results
Primary
Emotional Eating - 2-weeks Post-intervention
Emotional eating, as assessed by the Dutch Eating Behaviour Questionnaire Emotional Eating Subscale (DEBQ-EE). Participants are asked to rate the frequency with which they engage in particular eating behaviours, on a 5-point Likert-type rating scale from never (1) to very often (5), with higher scores reflecting higher emotional eating. Only the emotional eating subscale of the DEBQ will be assessed and is calculated by averaging the 13 items that assess emotional eating.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Emotional Eating - 2-weeks Post-intervention | 3.27 units on a scale | Standard Deviation 0.58 |
Primary
Emotional Eating - 3-months Post-Intervention
Emotional eating, as assessed by the Dutch Eating Behaviour Questionnaire Emotional Eating Subscale (DEBQ-EE). Participants are asked to rate the frequency with which they engage in particular eating behaviours, on a 5-point Likert-type rating scale from never (1) to very often (5), with higher scores reflecting higher emotional eating. Only the emotional eating subscale of the DEBQ will be assessed and is calculated by averaging the 13 items that assess emotional eating.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Emotional Eating - 3-months Post-Intervention | 3.10 units on a scale | Standard Deviation 0.55 |
Secondary
Ability to Stop Emotional Eating - 2-weeks Post-intervention
As assessed by a single self-report item developed by the study's authors. Participants were asked to report the number of instances in which they began to engage in emotional eating and were able to stop themselves, on a scale from 1 (none of the time) to 5 (very often).
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Ability to Stop Emotional Eating - 2-weeks Post-intervention | 2.68 units on a scale | Standard Deviation 1.12 |
Secondary
Ability to Stop Emotional Eating - 3-months Post-intervention
As assessed by a single self-report item developed by the study's authors. Participants were asked to report the number of instances in which they began to engage in emotional eating and were able to stop themselves, on a scale from 1 (none of the time) to 5 (very often).
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Ability to Stop Emotional Eating - 3-months Post-intervention | 2.71 units on a scale | Standard Deviation 1.01 |
Secondary
ACT Values Application - 2-weeks Post-intervention
Application of ACT values techniques taught during the workshop, as assessed by items developed by the study's authors. Participants were asked to rate the extent to which they agreed with a number of value-based statements on a scale from 1 (strongly disagree) to 5 (strongly agree). Values score was derived by taking the mean of the items, with higher scores reflecting greater value-consistent eating behaviors.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | ACT Values Application - 2-weeks Post-intervention | 3.79 units on a scale | Standard Deviation 0.63 |
Secondary
ACT Values Application - 3-months Post-intervention
Application of ACT values techniques taught during the workshop, as assessed by items developed by the study's authors. Participants were asked to rate the extent to which they agreed with a number of value-based statements on a scale from 1 (strongly disagree) to 5 (strongly agree). Values score was derived by taking the mean of the items, with higher scores reflecting greater value-consistent eating behaviors.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | ACT Values Application - 3-months Post-intervention | 3.63 units on a scale | Standard Deviation 0.66 |
Secondary
Distress Tolerance - 2-weeks Post-Intervention
Distress tolerance, as assessed by the Distress Tolerance Scale (DTS). Participants are asked to indicate the extent to which they agree with statements aimed at assessing distress tolerance, absorption, appraisal, and regulation from 1 (strongly agree) to 5 (strongly disagree), with lower scores reflecting lower distress tolerance. Subscale scores are derived by calculating the means of the items that make up each subscale. Total score is calculating by averaging the four subscales.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Distress Tolerance - 2-weeks Post-Intervention | 3.17 units on a scale | Standard Deviation 0.79 |
Secondary
Distress Tolerance - 3-months Post-Intervention
Distress tolerance, as assessed by the Distress Tolerance Scale (DTS). Participants are asked to indicate the extent to which they agree with statements aimed at assessing distress tolerance, absorption, appraisal, and regulation from 1 (strongly agree) to 5 (strongly disagree), with lower scores reflecting lower distress tolerance. Subscale scores are derived by calculating the means of the items that make up each subscale. Total score is calculating by averaging the four subscales.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Distress Tolerance - 3-months Post-Intervention | 2.87 units on a scale | Standard Deviation 0.86 |
Secondary
Emotional Eating Frequency - 2-weeks Post-intervention
As assessed by a self-report item developed by the study's authors. Participants were asked to report the number of times they engaged in emotional eating in the past week.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Emotional Eating Frequency - 2-weeks Post-intervention | 3.00 times per week | Standard Deviation 1.49 |
Secondary
Emotional Eating Frequency - 3-months Post-intervention
As assessed by a self-report item developed by the study's authors. Participants were asked to report the number of times they engaged in emotional eating in the past week.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Emotional Eating Frequency - 3-months Post-intervention | 3.43 times per week | Standard Deviation 1.67 |
Secondary
Feasibility Data: Recruitment, Eligibility, Attendance, and Attrition Rates
These include recruitment, eligibility, attendance, and attrition rates
Time frame: Assessed throughout the duration of the study from the recruitment period to the completion of the workshops and follow-up questionnaires (i.e., over a 3-month period).
Population: The population of analysis were the 59 individuals who initially expressed interest in the study.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Feasibility Data: Recruitment, Eligibility, Attendance, and Attrition Rates | Recruitment | 59 Participants |
| ACT Workshop for Emotional Eating | Feasibility Data: Recruitment, Eligibility, Attendance, and Attrition Rates | Eligibility | 44 Participants |
| ACT Workshop for Emotional Eating | Feasibility Data: Recruitment, Eligibility, Attendance, and Attrition Rates | Attendance | 32 Participants |
| ACT Workshop for Emotional Eating | Feasibility Data: Recruitment, Eligibility, Attendance, and Attrition Rates | Attrition | 2 Participants |
Secondary
Food Craving Acceptance and Action - 2-weeks Post-intervention
Food craving acceptance and action, as assessed by the Food Craving Acceptance and Action Questionnaire (FAAQ). Items are rated on a 6-point Likert-type rating scale from 1 (very seldom true) to 6 (always true), with higher scores reflecting higher acceptance. Total score is derived by summing all items. Minimum score is 10 and maximum score is 60.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Food Craving Acceptance and Action - 2-weeks Post-intervention | 32.71 units on a scale | Standard Deviation 4.29 |
Secondary
Food Craving Acceptance and Action - 3-months Post-intervention
Food craving acceptance and action, as assessed by the Food Craving Acceptance and Action Questionnaire (FAAQ). Items are rated on a 6-point Likert-type rating scale from 1 (very seldom true) to 6 (always true), with higher scores reflecting higher acceptance. Total score is derived by summing all items. Minimum score is 10 and maximum score is 60.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Food Craving Acceptance and Action - 3-months Post-intervention | 32.68 units on a scale | Standard Deviation 4.76 |
Secondary
Mindful Eating - 2-weeks Post-intervention
Mindful eating, as assessed by the Mindful Eating Questionnaire (MEQ). It is a 28-item self-report measure that assesses five domains of mindful eating: disinhibition, external cues, awareness, emotional response and distraction. Participants are asked to indicate the extent to which extent they agree with each item from 1 (never / rarely) to 4 (usually/ always), with higher scores reflecting higher levels of mindful eating. Total score is derived by taking the mean of the five subscales.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Mindful Eating - 2-weeks Post-intervention | 2.51 units on a scale | Standard Deviation 0.35 |
Secondary
Mindful Eating - 3-months Post-intervention
Mindful eating, as assessed by the Mindful Eating Questionnaire (MEQ). It is a 28-item self-report measure that assesses five domains of mindful eating: disinhibition, external cues, awareness, emotional response and distraction. Participants are asked to indicate the extent to which extent they agree with each item from 1 (never / rarely) to 4 (usually/ always), with higher scores reflecting higher levels of mindful eating. Total score is derived by taking the mean of the five subscales.
Time frame: Assessed from baseline to 2-weeks post-intervention and 3-months post-intervention
Population: Based on incomplete questionnaire data, 28/32 participants were included in the final analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ACT Workshop for Emotional Eating | Mindful Eating - 3-months Post-intervention | 2.65 units on a scale | Standard Deviation 0.41 |