Acceptance and Commitment Therapy (ACT)

At its foundation, ACT is based on the understanding that psychological distress often stems from an ongoing struggle to avoid or control unwanted emotions and experiences. For individuals with eating disorders or intense body image distress, this struggle frequently manifests as attempts to escape or neutralize uncomfortable thoughts about weight, shape, or self-worth through behaviors such as food restriction, binge eating, purging, or compulsive exercise. While these behaviors may offer temporary relief, they ultimately reinforce feelings of shame and a sense of loss of control.

Body image issues and body image preoccupation are well-documented risk factors for the development of eating disorders. When individuals become excessively focused on perceived flaws or invest their self-worth entirely in their physical appearance, it fosters a distorted sense of identity and fuels harmful eating patterns. ACT addresses this by helping individuals step back from body-related thoughts and recognize them as mental events—not facts that define who they are.

Rather than attempting to silence negative self-talk, ACT helps people cultivate awareness and acceptance of their internal experiences. The goal is not to eliminate distress but to reduce its power to dictate behavior. Through this process, individuals learn to live a life guided by personal values—such as health, authenticity, connection, and growth—even when challenging thoughts or feelings are present.

ACT is often used alongside other evidence-based therapies such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT). In sessions, patients engage in mindfulness exercises, experiential activities, and guided reflection to explore their relationship with food, body image, and emotions.

For example, an individual may practice mindful eating, noticing each sensation, thought, and emotion that arises without judgment. They may also learn to identify how avoidance behaviors—such as mirror avoidance, excessive body checking, or restrictive eating—conflict with their deeper values. Through exposure and mindfulness, ACT helps reduce both body image avoidance and body image preoccupation, teaching individuals to coexist with discomfort instead of trying to escape it.

This therapeutic process gradually breaks the cycle of rigidity and control that sustains eating disorders. It shifts the focus from achieving a “perfect body” to building a fulfilling, meaningful life. ACT’s emphasis on acceptance allows individuals to make peace with imperfection while committing to behaviors that support long-term well-being.

ACT helps individuals develop the psychological tools needed to face distressing emotions and thoughts without allowing them to govern behavior. It nurtures resilience, emotional balance, and self-compassion—qualities that counter the perfectionism, guilt, and shame often intertwined with disordered eating.

By broadening psychological flexibility, ACT helps individuals move from a place of fear and avoidance to one of engagement and purpose. They learn that discomfort is a natural part of being human and that meaningful action can coexist with imperfection. This newfound adaptability extends beyond eating behaviors, improving overall emotional health, relationships, and self-esteem.

Research supports the efficacy of ACT for individuals with eating disorders and chronic body image concerns. Studies show significant reductions in binge eating, purging, and food restriction behaviors, as well as decreases in body dissatisfaction and appearance-related anxiety. Importantly, improvements in psychological flexibility are strongly correlated with sustained recovery and lower relapse rates.

Psychological flexibility means the ability to stay present, open, and engaged in life even when faced with difficult thoughts, emotions, or experiences. It involves accepting internal discomfort when necessary and still taking actions that align with one’s values rather than reacting impulsively or avoiding distress.

In other words, instead of trying to control or eliminate painful feelings (which often makes suffering worse), ACT teaches people to accept what they can’t control and commit to meaningful actions that move them toward the life they want to live.

The guiding aim of ACT is to cultivate psychological flexibility, which in turn supports mental health, emotional resilience, and overall well-being.

ACT’s success lies in helping people fundamentally change how they relate to themselves. Patients often describe feeling less trapped by negative thoughts and more able to live according to their values. They report improved mood, better emotional regulation, and greater satisfaction in relationships and daily life. Over time, ACT empowers individuals to view their bodies with neutrality and respect, rather than judgment or fixation.

The central goal of Acceptance and Commitment Therapy (ACT) is to help individuals develop psychological flexibility. Everything within ACT—its six core processes, mindfulness exercises, acceptance strategies, and values-based actions—serves this overarching purpose.