Running Head: ACT AND EATING BEHAVIORS 1

The Effects of Acceptance and Commitment Therapy-Based Exercises on Eating

Behaviors in a Laboratory Setting

Mia C. Brousseau

Master of Science (APPLIED BEHAVIOR ANALYSIS)

May 2019

University of Southern California

 ProQuest Number: 27791112

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ACT AND EATING BEHAVIORS 2

Table of Contents
Abstract…….…………………………………………………………………………………….…………3
1.0 Introduction…………….………………...………...………………………………………………4
1.1 Acceptance and Commitment Therapy…………………………...……..……4
Mindfulness-based cognitive therapy and disordered eating……………………....5
Mindfulness attention induction and disordered eating……………………………...5
Mindful eating and food intake………………………………………………………................6
Mindfulness and reduced consumption of high calorie foods……………………....7
ACT, binge eating, and subclinical eating pathology…………………………………….7
Mindfulness and weight loss………………………………………………………………………8
2.0 Methods……….…………………………………………………………………………………….…9
2.1 Participants and Setting…………………………………………..………………….8
2.2 Response Measurement and Interobserver Agreement…………..….9
2.3 Procedures……....…………………...…………………………………………………..10
Design………………………………………………………………………………..…………………...10
Screening and Preference Assessments………………………………….…………………10
Informed Consent……………………………………………………………………..……………..11
Baseline…………………………………………………………………………………………………..11
Preliminary ACT Training……………………………………………………………….………..11
ACT Condition……………………………………………………………...………………………….13
Post-training……………………………………………………………………….…………………..15
Debriefing……………………………………………………………………………………………….16
3.0 Results…………………………………………………………………………….………………….16
4.0 Discussion………………………………………………………………..………………………...18
References…………………………………………………………………….………………………….25
ACT AND EATING BEHAVIORS 3

ABSTRACT:

Mindfulness-based strategies such as those used in Acceptance and Commitment

Therapy (ACT) are increasingly used for craving and weight management as well as
for behaviors related to disordered eating. A growing body of research in the clinical
psychology literature provides evidence that these approaches can be effective in
changing eating behaviors. However, few studies have examined the effects of these
strategies in controlled settings, while separating components of the strategies
accountable for success. Fewer still have attempted to identify the behavioral
mechanisms that may be responsible for behavior change in these interventions.
This study evaluates ACT-based strategies and their effects on the eating behaviors
of four participants in a laboratory setting. A multiple baseline design across
participants is used to assess the efficacy of an ACT-based intervention that involves
the application of ACT exercises during choices between healthy versus non-healthy
foods. Throughout this process the ACT exercises were gradually faded out and
indirect data were taken on generalization of healthy food consumption to the
participants’ natural environment.
ACT AND EATING BEHAVIORS 4

The Application of Acceptance and Commitment-Based Therapy Exercises to Improve

Healthy Eating Behaviors

1.0 Introduction

About three-fourths of the U.S. population has an eating pattern that is low in

vegetables, fruits, and oils and exceeds recommendations for added sugars, saturated fats,

and sodium (National Health and Nutrition Examination Survey, 2015). Food

consumption is linked to some of the leading causes of preventable death and diseases

such as: heart disease, diabetes, obesity, high blood pressure, stroke, osteoporosis, and

various cancers (Center for Science in the Public Interest (CSPI), 2016). Therefore, it is

important to eat a varied diet including plant-based foods to decrease the likelihood of

preventable death and disease. Current efforts to promote healthy eating are insufficient,

as obesity rates in the past 30 years have doubled in adults (CDC), tripled in children, and

quadrupled in adolescents (Ogden, 2015).

1.1 Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT), is an empirically based

psychological intervention that uses acceptance and mindfulness strategies with

commitment and behavior change strategies to increase psychological flexibility (Hayes,

Strosahl, & Wilson, 1999). ACT has been used on a variety of populations of individuals

such as those with; substance abuse, psychosis, anxiety, depression, chronic pain, and

eating disorders (Ruiz, 2010). Although numerous studies applying ACT-based

procedures have addressed disordered eating behaviors in the context of eating disorders,

few studies have used these procedures to promote healthy eating habits in those who do

not necessarily display disordered eating but wish to improve their eating habits.
ACT AND EATING BEHAVIORS 5

Mindfulness-based cognitive therapy and disordered eating. Alberts and Raes

(2012) conducted a study in which 26 women who reported having disordered eating

were split into two groups. One group was the mindfulness-based cognitive therapy

(MBCT) intervention group and the other group of individuals was placed on a waiting

list for the intervention. Although described as a cognitive therapy and not ACT, per se,

MBCT contains multiple components that overlap highly with the ACT model of

psychological flexibility. The MBCT-intervention included components such as: mindful

eating, awareness of physical sensations, awareness of relevant thoughts and feelings,

acceptance, and awareness of daily habits. Outcomes were measured via weight check-

ins and multiple questionnaires related to body shape, mindfulness, eating behavior,

dichotomous thinking, and general food craving. Twelve participants were assigned to

the treatment group, while fourteen were assigned to a waiting-list control group. The

waiting-list period lasted for the duration of the treatment period, which was 8 weeks.

The intervention consisted of 8 weekly sessions lasting 2.5 hours and participants were

invited to practice all exercises learned in the sessions during time at home for

approximately 45-60 minutes a day. They found that lower levels of food cravings,

dichotomous thinking, body dissatisfaction, emotional eating and external eating were

reported after the intervention period, compared to a waiting list control group. No direct

measures of behavior were included as dependent variables.

Mindfulness attention induction and disordered eating. Fisher et al. (2016)

conducted a group design study with forty participants in a university setting in which

they included a mindfulness attention induction script in the experimental condition

compared to an attention control condition. They assessed cravings and food intake using
ACT AND EATING BEHAVIORS 6

multiple mindfulness and craving questionnaires and measured food intake in a

laboratory setting. The forty participants were split evenly between the control and

intervention groups. The study of pretest measures on appetite, state mindfulness, and

mood followed by 10 minutes of either mindfulness induction or a control task. Then 10

minutes of a food-cue exposure task was conducted in which participants were exposed

to two food items and were instructed to hold, smell, and touch the foods to their lips.

They were instructed not to consume or taste the foods during this task. After the food

exposure task post-test measures were taken on appetite, state mindfulness, mood, and

state craving. An additional 10 minutes of either mindful self-practice or sitting was

conducted in the presence of cued foods. At the end of delay, measures on appetite, state

mindfulness, mood, state craving, and desire for cued foods was taken followed by a food

intake measurement and exit questions. The results showed that attention with a mindful

attitude may promote better eating behaviors in the short-term, and adds to the evidence

base justifying the examination of components of mindfulness-based interventions within

the context of obesity prevention and management. A strength of this study is the

inclusion of a direct measure of food intake as a dependent variable.

Mindful eating and food intake. Seguias and Tapper (2017) conducted a group

design study with 51 participants recruited at a university in which they examined the

effects of applying a mindful eating strategy during lunch times and measuring the effects

of memory of food intake later in the day. The two conditions of this study consisted of a

control group in which participants ate lunch with no audio recording and an

experimental group consisting of a mindful eating strategy. The mindful eating strategy

consisted of an audiotape that played during mealtime focusing on bringing the

ACT AND EATING BEHAVIORS 7

participants attention to the properties of food. The measurements taken throughout this

study included: (a) heartbeat through an electrocardiogram (ECG); (b) questionnaires on

appetite, memory, and reinforcement; (c) a sensitivity theory personality questionnaire;

(d) demographics; and (e) snacking, and dieting status. They found that results of mindful

eating were not moderated by interoceptive awareness and no significant differences

were found in memory. They also found reductions in afternoon snack consumption

when mindfully eating in the lunch condition.

Mindfulness and reduced consumption of high calorie foods. Several studies

have evaluated the effects of mindfulness using group designs to reduce consumption of

high calorie foods such as chocolate (Forman, Hoffman, Juarascio, Butryn, & Herbert,

2013, Hooper, Sandoz, Ashton, Clarke, & McHugh, 2012, Jenkins and Tapper 2014,

Moffitt, Brinkworth, Noakes, & Mohr, 2012). Two of these studies found no significant

differences among groups when comparing ACT-based interventions to control groups

and the third study found a reduction in high calorie food consumption in the defusion

condition, but not the acceptance and control conditions. The last study found lower

levels of food consumption in the mindfulness-related condition compared to the

cognitive restructuring and control conditions.

ACT, binge-eating, and subclinical eating pathology. Several other studies

have assessed the use of ACT-based interventions for treating binge eating symptoms and

subclinical eating pathology (Baer, Fischer, & Huss, 2006, Dalen, Smith, Shelley, Sloan,

Leahigh, & Begay, 2010, Hill, Masuda, Moore, & Twohig, 2015, Juarascio, Forman, &

Herbert, 2010, Kearney, Milton, Malte, McDermott, Martinez, & Simpson, 2012,

Kristeller and Hallet 1999, and Strandskov, Ghaderi, Ansdersson, Parmskog, Hjort,
ACT AND EATING BEHAVIORS 8

Warn, & Andersson, 2017). All seven of these studies using ACT-based interventions

resulted in substantial improvements in symptoms such as: frequency of binges and

binge-related concerns, depression, perceived stress, physical symptoms, emotional

eating, and uncontrolled eating.

Mindfulness and weight loss. Several studies have also evaluated the use of

mindfulness-based strategies on weight loss for individuals with motivation to lose

weight (Mantzios & Wilson 2015, Miller et al. 2012). The study conducted by Mantzios

& Wilson (2015) included 62 military employees across three groups. The two

mindfulness intervention groups consisted of mindfulness meditation alone and

mindfulness meditation combined with self-compassion, while the control group

consisted of dieting only. The 5-week study assessed outcomes on weight and BMI. The

results showed that both experimental groups improved significantly compared to the

control group and that mindfulness with self-compassion was more effective than

mindfulness alone.

In summary, a variety of research supports the potential utility of mindfulness-

based approaches to improving eating, but little previous research has assessed the effects

of these strategies on direct measures of behavior. In addition, very little research on

mindfulness based approaches to improving eating have used single case designs, which

can be effective in identifying the effects of interventions on the behavior of individual

participants. The purpose of the current study was to evaluate the effects of ACT-based

strategies on the eating behaviors of individuals in a laboratory setting using a single-case

design. The eating behaviors measured in this study included both healthy and non-

healthy choice making, and complete consumption of each choice made.

ACT AND EATING BEHAVIORS 9

2.0 Method

2.1 Participants and Setting

The participants included four undergraduate college students, with no prior

diagnoses of eating related disorders, at least 18 years of age, had access to an electronic

device with the application “myfitnesspal”, and spoke fluent English. The study took

place in a 6 m x 6 m lab meeting room, equipped with tables and chairs. Participants were

compensated in the form of $5 for every 30 minutes of time spent in the laboratory.

Compensation was not contingent on any specific outcomes and instead contingent on the

duration of time spent participating in the study.

2.2 Response Measurement and Interoberver Agreement

The dependent variables that were measured throughout this study were choice

and complete consumption of healthy and unhealthy foods on each trial. IOA was

collected for 73% of sessions and observers obtained 100% agreement. Social validity

was assessed through a written assessment at the conclusion of the study for each

participant. Examples of social validity assessment questions covered areas such as

validity of outcomes, procedures, goals, and external validity. Participants used an

application on their mobile phones to record their food consumption for one day before

and one day after participation. Data from the food logs were scored according to four

categories of foods. “Specified foods other than fruits and vegetables” were defined as

any food item listed as preferred on the initial preference assessment. “Specified fruits

and vegetables” were defined as any food item listed as non-preferred on the assessment.

“Unspecified foods other than fruits and vegetables” were defined as food items not listed

on the assessment and not vegetables of fruits. “Unspecified fruits and vegetables” were
ACT AND EATING BEHAVIORS 10

defined as food items not listed on the assessment including only vegetables and fruits.

These four categories were used because all participants expressed a desire to increase

their consumption of fruits and vegetables.

2.3 Procedures

Design. A multiple baseline design across participants was used, consisting of the

following phases; baseline, ACT training, and post-training.

Screening and Preference Assessment. Participants were screened for any

potential food allergies prior to participation. For a food to be included in the study, the

participant must have stated that they have consumed it at least once in the past with no

evidence of a reaction to the foods. A brief preference assessment was conducted at the

beginning of the study in which each participant was asked to list ten highly preferred

unhealthy foods that they wish they would eat less of and ten healthy low-preferred foods

that they do not currently eat but wish that they did. They were asked to rank order these

food items according to how problematic the unhealthy foods were and which healthy

foods they would prefer to work on. Participants were also asked questions pertaining to

their motivation for healthy eating and what current supports they have in their life for

eating related goals. Participants were made aware at the beginning of the study that our

goal is to help them make healthier choices and increase their healthy food consumption.

Questions pertaining to response effort and food availability were also asked during the

screening process such as common stores they shop at to purchase foods, how often they

eat out and where, and other general eating habits.

ACT AND EATING BEHAVIORS 11

Informed Consent. During the first study visit, each participant received and

signed a document with a brief description of the study as well as their rights as a

research participant in this study.

Baseline. Prior to the start of food choice trials participants were asked about

whether they had eaten within the last 2 hours. Food choice trials commenced if the

participant had reported they did not eat within the last two hours. During each trial in

baseline the participants were presented with two food options, one healthy food option

and one unhealthy food option, based on individual preference assessments. One bite of

each food item was presented as a trial and participants were instructed to “pick one”.

After a choice was made the remaining item was removed from the table. Trials rotated

randomly through several different healthy and several different unhealthy foods.

Generalization probes for food consumption outside of the laboratory setting were

included in the baseline phase. Participants were asked to download a free application on

their phone or other electronic device that provided them with the tools for tracking their

food intake and sharing it with the researcher. The participants were asked to record their

consumption of food for one full day prior to the start of the baseline phase of

intervention in the natural environment, as well as after intervention. They were asked to

track the full day of food consumption for one of the three days leading up to the

beginning of baseline and for no longer than three days after the last post-training trial.

Preliminary ACT-training. This training period consisted of practicing a general

mindfulness-based exercise such as “five senses” or “mindful meditation”. Food choices

were not presented during this training period and no measurements were in place. This
ACT AND EATING BEHAVIORS 12

condition was solely for the purpose of allowing the participants to gain practice in being

mindful during guided exercises.

Five senses (Stoddard & Afari 2014). The participant was asked to look around

and notice five things that they haven’t noticed before, whether it is a pattern on the wall,

reflection of light on a surface, or an object placed in a corner of the room. The

participant was then asked to notice four things that they feel. This could be the feel of

their clothing, the feel of a breeze, or the feel of the pressure of their hands on a surface.

They then were asked to notice three things that they can hear, such as background

sounds, air conditioning noise, or cars in the distance. Next, the participant was asked to

notice two things that they can smell such as flowers, coffee, or air freshener. Lastly, the

participant was asked to notice one thing that they can taste, such as a piece of gum or

just how their mouth tastes.

Mindful Meditation (Stoddard & Afari, 2014). The participant was asked to find a

comfortable position to sit for a few minutes. They were asked to start by noticing their

breath by paying attention to how it enters and then leaves their body. They were told to

notice as their mind begins to wander and pull them out of the present moment. The

participants were then asked to notice their thoughts and feelings as if they were an

outside observer watching what happens inside their brain while taking note of this they

were asked to return back to noticing their breathing. If their mind begins to wander, they

were asked to notice where the thoughts were going and to accept them as they were

happening. They were told to try and return to their breathing and continue this process

for a few more moments.

ACT AND EATING BEHAVIORS 13

ACT Condition. After the initial ACT training, food choice trials were continued

as in baseline. This condition was identical to baseline with the addition of the ACT-

based exercises that were guided intermittently between trials, depending on the

participants’ response to the intervention. All participants started the ACT condition by

engaging in the exercises pertaining to mindfulness and based off of visual inspection and

feedback from the participants, decisions were made on which of the other ACT-based

exercises were subsequently implemented (i.e. values, defusion, etc.). Contingent on two

out of three consecutive trials in which unhealthy food was chosen, participants were

guided through an additional ACT exercise and then instructed to apply the exercise to

the next food choice trial. The additional exercises are described below.

Mindful Eating (Stoddard & Afari, 2014). This present-moment awareness

exercise consisted of first noticing how the food looked on the table, then picking up the

food and noticing the weight of it and how it felt against your skin. Then the participant

was asked to notice its texture and any other properties of the food. The participant was

asked to notice the smell of the food. Next the participant was asked to put the food in

their mouth on top of their tongue without eating it and to observe how it felt there and

any taste it has. They were asked to roll the food around their mouth and pay attention to

the feeling. Lastly, the participant was asked to slowly chew the food and notice how the

texture changes and how it tasted as it spread across their tongue. They were asked to

notice if their mouth began to fill with saliva and the temperature it left on their tongue.

The participant was told to notice all of these sensations until they had finished eating the

food. None of the target healthy or unhealthy foods were used during the mindful eating

exercise (i.e., other healthy foods were included).

ACT AND EATING BEHAVIORS 14

Mindful Bodyscan (Stoddard & Afari, 2014). The participant was asked to pay

close attention to physical sensations throughout their body without trying to change or

relax their body but instead to just notice how they become more aware of it. The

participant was told to begin by paying attention to their feet first by noticing the warmth,

coolness, pressure, pain, or even a breeze over the skin. They were asked to slowly move

the noticing of sensations up their body to their calves, thighs, pelvis, stomach, chest,

back, shoulders, arms, fingers, neck, and then their head. After they have traveled all the

way up their body they were asked to begin to move back down through each body part

until they reach their feet again.

Responding to Triggers (Stoddard & Afari 2014). This defusion exercise involved

bringing out a highly desired food, presumably unhealthful, and allowing the participant

to see and smell it and then describe some thoughts, feelings, and cravings they

experience in the presence of the food item. The participant was provided with a paper

and pen during this exercise and asked to write down these thoughts, feelings, and

cravings. As the participant shared what they wrote down the individual running the

exercise began to label each of these as thoughts, emotions, or cravings so the participant

could experience the distinctions. They were then asked to explore different ways of

relating to the cravings using the metaphor of a wave to help them consider the

possibility of just experiencing cravings as they rise and fall without acting on them.

Values Bull’s Eye (Lundgren et al. 2012). This exercise included a worksheet with

an outline of concentric circles that are split along the lines of a compass. Each quarter of

the bull’s eye represents a part of the individual’s life. These parts included;

work/education, leisure, personal growth/health, and relationships. First the participants

ACT AND EATING BEHAVIORS 15

were asked to list their values for each of the parts in their bull’s eye model. The values

that are listed were here and now rather than goals for the future, they did not need to be

justified but did need to be prioritized, held tightly, and freely chosen. The participant

was asked to write each value beside each of the areas they relate to. The participant was

asked to prioritize their top three values by either marking them with a symbol or

highlighting them. Once all the values were identified and written in the areas, they were

asked to mark where they stand with their values today. The participant was asked to

revisit the bull’s eye worksheet at a later time to mark their progress or regression

towards their values.

Drop the Anchor (Harris, 2011). This exercise consisted of having the participant

stand up and plant their feet into the ground while noticing the muscle tension in their

legs. They were asked to bring their awareness to the sensations of gravity moving down

their spine and into their feet and to notice their surroundings and any internal private

events. The participant is asked to count cycles of five deep breathes while noticing the

way their chest expands and compresses.

After a consistent effect was demonstrated, guided ACT exercises were faded

gradually and systematically, based on visual inspection of the data. The frequency of

ACT exercises was faded over the course of stable healthy choices until only vocal

reminders to make choices mindfully were given. Vocal reminders were faded out

gradually until healthy choice making maintained in the absence of reminders. Choice

making was considered to be stable after 2 consecutive choices of a healthy food item.

Post-training. Post-training trials were identical to baseline.

ACT AND EATING BEHAVIORS 16

Debriefing. At the conclusion of all data collection the participants were

debriefed on the overall purpose and processes used throughout the study as well as the

outcomes attained. Participants were given the opportunity to ask any questions about the

study and its conclusions.

3.0 Results

Figure 1 depicts the complete consumption of both healthy and unhealthy food

options on a cumulative graph. All participants completely consumed bites of the

unhealthy food option during the baseline phase with the exception of participant 4 who

intermittently chose the healthy choice. Initially, participants 1, 2, and 3 did not consume

the healthy food choice option in the ACT condition, but for participants 2 and 3 they

began to choose and consume the healthy food item option over the unhealthy food item.

Participant 1 did not reliably choose the healthy option during the mindfulness portion of

the ACT training but began to choose the healthy option after the values portion of the

ACT training was introduced. Participant 4 immediately chose the healthy option after

starting the ACT condition and reliably chose the healthy option for the remainder of the

phase. During the post-training phase participants 1, 2, and 3 consistently consumed the

healthy food item over the unhealthy food item for the entire post-training phase.

Participant 4 consumed the healthy option for the majority of the post-training phase with

the exception of one unhealthy food item choice before returning back to consuming the

healthy food item.

Figure 2 depicts the food log data for participant 1 in the baseline and post-

training phases. In the baseline phase participant 1 had eaten 0% of servings that were

categorized as fruits or vegetables and in the post-training phase 60% of the foods eaten
ACT AND EATING BEHAVIORS 17

were categorized as fruits or vegetables. Figure 3 shows the food log data for participant

2 in the baseline and post-training phases. In the baseline phase participant 2 consumed

21% of servings that were categorized as fruits or vegetables. In the post-training phase,

they consumed 41% of servings that were categorized as fruits or vegetables. Figure 4

depicts food log data for participant 3 during the baseline phase. During baseline

participant 3 consumed 9% of servings categorized as fruits or vegetables. Post-training

food log data was not provided by participant 3. Figure 5 represents the food log data for

participant 4 during baseline and post-training phases. Participant 4 consumed 50% of

servings categorized as fruits or vegetables in the baseline phase and 40% of servings

categorized as fruits or vegetables in the post training phase. Figure 6 displays the

specific ACT exercises that were used for all four participants in the sequential order that

they were delivered in.

Figure 7 shows the social validity data based off of an assessment provided to all

four participants. On a scale of 1 (strongly disagree) to 5 (strongly agree), on average,

participants rated a 4 for the agreement of the procedures of this study helping them make

healthier choices in the lab. All participants rated a 5, in agreement to the mindfulness

procedures being easy to follow. All participants strongly agreed that they valued the goal

of eating healthier. On average, participants agreed that the mindfulness exercises used

were helpful in their daily life. All participants strongly agreed that the mindfulness

procedures were enjoyable overall. Figure 8 displays a table of foods included in the

study based on each individual preference assessment. All participants were provided

three choices in each category with the exception of participant 4 who expressed that one
ACT AND EATING BEHAVIORS 18

of the healthy food items included was no longer a valuable food to begin consuming and

was therefore, excluded from the study.

4.0 Discussion

These results suggest that ACT-based interventions are effective in directly

influencing healthy eating behaviors by improving healthy choices and increasing amount

of consumption of healthy options while decreasing consumption of unhealthy food

options in the laboratory. The ACT-based interventions were successful in showing

immediate behavior change as well as success in fading out the guided practices

demonstrating generalization of the practices, at least across foods within the laboratory.

Due to the increasing rates of preventable disease and death caused by eating

related personal health decisions these findings have implications towards the

effectiveness of ACT-based interventions for improving healthy eating in populations

who may be at risk or may wish to improve their current eating habits. Results of this

study suggest that mindfulness-based and value’s exercises may help to increase

immediate healthy food choice making.

One limitation of this study is that it was conducted in a lab setting in which some

reactivity could have occurred due to the unnatural setting of eating behavior. Because

this was an initial study, no attempt was made to produce generalization of the effects of

the intervention outside of the lab and therefore no formal data were collected to test any

such generalization. An objective evaluation of how ACT-based interventions can affect

healthy eating behaviors outside of the lab context and in the individuals’ daily lives

should be an area of future research.

ACT AND EATING BEHAVIORS 19

Another limitation of this study is that the function of each individual’s unhealthy

eating behaviors was not identified prior to the start of the study. It is highly recognized

in the field of applied behavior analysis that interventions take a function-based

approach. It is possible that unhealthy food choices involve negative automatic

reinforcement in the form of escape from non-preferred foods and positive automatic

reinforcement in the form of access to preferred foods. If this is the case, it is possible

that mindful eating exercises work because they decrease or disrupt the aversive stimulus

functions of healthy foods and/or add new verbally mediated functions through relational

framing and transformation of stimulus functions. However, this study made no attempt

to assess the function of unhealthy choice making during baseline and no systematic

attempt to identify whether mindful eating was effective due to these functional variables.

Therefore, another area of future research would be to assess the function of the

individual’s own eating behaviors and attempt to identify the behavioral mechanisms

responsible for the effectiveness of mindful eating interventions.

Future studies should examine how these procedures could be adapted for use in

schools to establish mindful eating repertoires early on in life or during periods of life

change such as starting college. Future research should also look to adapt and evaluate

the effectiveness of these procedures for populations struggling with obesity, diabetes, or

other ailments related to food consumption. Future studies should also investigate the

effects of specific ACT processes on eating behavior by conducting a component analysis

so as to identify the effective variables in altering an individual’s eating behavior. Lastly,

an area for future research studies could be to improve the efficiency and reduce response
ACT AND EATING BEHAVIORS 20

effort of establishing mindfulness repertoires by creating an app or building group

instruction mindfulness programs for healthy eating.

ACT AND EATING BEHAVIORS 21

Figure 1. Number of cumulative choices completely consumed for healthy and unhealthy

options.
ACT AND EATING BEHAVIORS 22

Figure 2. Food log results for participant 1 during baseline and post training phases.

Figure 3. Food log results for participant 2 during baseline and post training phases.
ACT AND EATING BEHAVIORS 23

Figure 4. Food log results for participant 3 during baseline phase.

Figure 5. Food log results for participant 4 during baseline and post-training phases.
ACT AND EATING BEHAVIORS 24

Participant 1 Participant 2 Participant 3 Participant 4

Five Senses Five Senses Five Senses Five Senses

Mindful Eating Mindful Eating Mindful Eating Mindful Eating

Body Scan Body Scan Body Scan Body Scan

Mindful Eating Mindful Eating Drop the Anchor Drop the Anchor

Drop the Anchor Mindful Eating Mindful Eating -

Mindful Eating Responding to Triggers Mindful Eating -

Mindful Eating - Notice 5 Things -

Value’s Bullseye - - -

Value’s Bullseye - - -

Figure 6. ACT exercises for each participant in sequential order.

Figure 7. Social validity results for all four participants.

ACT AND EATING BEHAVIORS 25

Figure 8. Food included in the study based off of a list of preferred unhealthy foods and

nonpreferred healthy foods rank ordered by each participant.

 ACT AND EATING BEHAVIORS 26

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