The acceptability, feasibility and preliminary efficacy of acceptance and commitment therapy for adolescents in the management of overweight or obesity: A scoping review

This preregistered review sought to appraise what interventions have been developed and trialled applying acceptance and commitment therapy (ACT) for weight management in adolescents with regard to the acceptability, feasibility of and benefit that such interventions offer to participants. The impact of ACT on eating behaviour, weight management and wellbeing were of particular interest. Studies based on ACT interventions as a treatment for adolescents (age 11-18 years) with overweight or obesity were included in this review. No limits to language or search date were implemented. Systematic searches of the literature were conducted using the following databases - Medline, Scopus, Embase, Web of Science and PsycInfo. International Standard Randomised Controlled Trial Number, Clinical-Trials.gov, Cochrane Central Register of Controlled Trials, National Institute for Health and Care Excellence and OpenGrey were also searched. The studies were collated, data was extracted, and a narrative analysis was conducted. Cincinnati Children's Hospital Medical Centre's Let Evidence Guide Every New Decision evidence evaluation tools and resources were used for assessing studies' quality. Searches identified 267 texts that were retrieved for screening. Following review by two independent authors, 13 texts detailing the work of six ACT interventions were included. The quality assessment showed that there is currently a low body of evidence for recommending ACT for the treatment of adolescents with overweight or obesity. Yet, the acceptability of ACT based interventions was high, with strong attendance and high retention rates. Participation in ACT-based interventions demonstrated some evidence that key ACT processes may yield support for weight change. For example, improvements in outcomes such as psychological flexibility and weightrelated experiential avoidance indicate improved aspects of self-regulation. These findings in adolescents align with similar research in adults. While only six ACT-based interventions for weight management in adolescents have been developed to date, evaluating the related findings generated thus far offers opportunities to optimise the delivery and measurement of ACT approaches in future intervention designs. High quality, fully powered trials are now needed to increase the evidence for the beneficial effects of ACT for weight management.