| Summary: | Weight-related psychological difficulties (WRD) are associated with overweight and obesity including among young adults. We developed a program called ACT-EX (Acceptance and Commitment Therapy with Exercise), which incorporates six processes to increase weight-related psychological flexibility: acceptance, cognitive defusion, being present, self-as-context, values, and committed action for young adults who are overweight or obese (OW/OB). This open trial evaluated the feasibility, acceptability, and efficacy of the ACT-EX program. Fifty young adults who were OW/OB (78% female, 22% male; mean age = 21.32 years (SD = 1.2); Body Mass Index (BMI) = 30.01 kg/m2 (SD = 4.63); 36% Malay; 28% Bumiputera Sarawak; 20% Chinese; and Bumiputera Sabah and Indians, 4% each) participated in a 6-week intervention and 6-week follow-up study. The WRD was measured by the Acceptance and Action Questionnaire for Weight-Related Difficulties Revised-18 (AAQW-R18). The ACT-EX program was well accepted. Significant decreases were seen in WRD in the post-intervention program and at the 6-week follow-up time (p < 0.05) and BMI (p < 0.05). Participants who participated in the intervention program showed a significant weight loss. This trial provides preliminary evidence for the feasibility, acceptability, and efficacy of the ACT-EX program among young adults who are OW/OB. In conclusion, the ACT-EX showed beneficial effects on reducing WRD and improving BMI. A controlled and randomized trial is warranted to further examine the effectiveness of ACT intervention in behavioral and weight management. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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