"Most people assume the best way to motivate themselves is through harsh criticism" ... Dr Joseph Ciarrochi. Photo: Melanie Russell
When it comes to the urge to eat junk food or avoid exercise, acceptance and commitment therapy says: don't fight it, resistance is futile.
Confoundingly, however, acceptance and commitment therapy (ACT) is attracting growing recognition for its effectiveness when it comes to getting people to eat less and exercise more.
ACT is a mindfulness-based arm of cognitive behavioural therapy and part of what's known as the third wave of behaviour therapy. In very simple terms, where cognitive behavioural therapy asks people to challenge their unhelpful thinking, ACT asks them to accept it, distance themselves from it, move past it towards a meaningful goal and accept any discomfort that might entail. That pain and suffering are a normal, inevitable part of life is one of its central tenets.
ACT's best-known Australian proponent is Russ Harris, author of the best-selling self-help book The Happiness Trap. He has teamed up with Joseph Ciarrochi, a research psychologist from the University of Western Sydney, and Ann Bailey, a senior clinical psychologist, to devise an ACT-based program for weight loss and wellbeing.
Titled Weight Escape, it runs as a one-day workshop with a 10-week e-course follow-up. Weight Escape the book will be published by Penguin next year.
The idea of ''self compassion'' is key to the program even though it makes a lot of people squirm. ''Most people assume the best way to motivate themselves is through harsh criticism,'' Professor Ciarrochi says. ''They're actually quite afraid of being nice to themselves … [they associate it] with weakness and indulgence, but we show them motivation through kindness.''
Other components of the program include: eating mindfully (paying close attention to texture, aroma and flavour as well as satiety and hunger signals); distancing yourself from seemingly powerful urges (such as ''I must eat chips'' or ''I'm too tired to exercise''); finding the rewards in positive behaviours, altering cues related to bad habits and committing to your values.
More than 60 randomised-controlled trials have found ACT to be effective when it comes to improving wellbeing, says Ciarrochi, who has personal experience of its benefits.
''It helped me lose 10 kilos and go from being fairly sedentary to exercising about six hours a week,'' he says.
The trials include a 2009 study published in the journal Pain, which followed 62 women trying to lose weight. The participants who applied ACT principles lost an average of 2.32 kilograms in six months. The control group lost less than 1kg. The ACT group was also ''engaged in significantly more physical activity than the control participants'', Ciarrochi says.
Another 2009 study, published in the Annals of Behavioral Medicine, found that of 84 participants who had recently lost weight, those who applied ACT principles lost a further 1.6 per cent of their body weight after three months, whereas the control group had regained a small amount of weight.
Several recent studies have also shown that ACT can motivate bariatric surgery and cardiac patients, as well as overweight and obese individuals to reduce emotional eating and undertake regular exercise.
CASE STUDY: MARCIA DARLING
Marcia Darling, 60, is a veteran of ''those classic, high-stress sorts of diets where you deny yourself everything and then you get to the stage where you can't cope with it any more''.
Her weight, along with her calorie intake, fluctuated for decades.
About two years ago, she started trying to improve her eating in a steadier, more sensible way, and then happened across a Weight Escape seminar in Brisbane.
''It gave me the impetus to keep going,'' she says.
Today, she finds herself fitting into clothes four sizes smaller and feeling a lot more relaxed about food and weight.
''I think I've lost 20, maybe 25, kilos,'' she says. She doesn't really know because she's given up weighing herself. ''I just go by clothing sizes.''
Weight Escape does not offer explicit dietary advice.
''I followed my own eating plan, and the whole thing was easy, relaxed,'' Darling says. ''What stood out for me was the idea that you are successful as soon as you start living by your values - in this case healthy eating, healthy living.
''You don't have to lose five kilos or 20 kilos to be successful. If I did a bit of yoga or reduced the size of a meal or drank a bit more water, I was already successful. That was very freeing.
''And also when they said to expect setbacks. It's perfectly natural, then you just carry on. It took all that stress away. You get very uptight when you diet.''
ACT principles as used in Weight Escape include:
Accepting uncomfortable feelings ''in the service of things you care about'', says Ciarrochi.
Being kind to yourself.
Accepting that setbacks are part of being human and pushing on towards your goals.
Using mindfulness or non-judgmental awareness. This includes mindful eating: paying close attention to flavours and textures as well as sensations of hunger and satiety.
Distancing yourself from unhelpful thoughts and feelings, taking them less seriously.
Committing to your values, what's most important to you.
Defining success not by falling numbers on the scale but on commitment and adherence to healthy behaviours.