Preliminary effectiveness of a culturally adapted Acceptance and Commitment Group Therapy (ACT-G) on weight-related struggles among Malaysian women with overweight or obesity: A randomized controlled trial

The prevalence of overweight and obesity, particularly among women, has risen significantly, leading to a global epidemic. Acceptance and Commitment Therapy (ACT) has proven effective in addressing weight-related psychological struggles, reducing weight self-stigma (WSS), and enhancing well-being. This study aims to evaluate the effectiveness of a culturally adapted Acceptance and Commitment Group Therapy (ACT-G) in reducing WSS, experiential avoidance (EA), and body mass index (BMI) among Malaysian women with overweight and obesity. The study employed a randomised controlled trial, including pre-test, post-test, and follow-up test assessments. Sixty-five Malaysian women with a BMI of 23 kg/m2 or above were recruited and randomly assigned to either the experimental group, which received the ACT-G intervention, or the waitlist control group. Non-parametric tests such as the Friedman test, Wilcoxon Signed-Rank test, and Mann-Whitney U test were employed to compare the outcomes of the experimental group with those of the control group. The findings revealed that ACT-G significantly outperformed the waitlist control group in both short-term and long-term measures. Specifically, participants in the ACT-G group experienced greater reductions in WSS, EA, and BMI. To summarize, this study generated positive findings supporting the viability of culturally adapted ACT-G as an effective approach to address weight-related struggles in Malaysia. The intervention aligns with Malaysian values and beliefs and shows promising preliminary efficacy; thus, this is a proof of concept and warrants further study.