ACCEPTANCE AND CHANGE IN THE TREATMENT OF EATING DISORDERS AND OBESITY

Recently it has been argued that the explicit focus on behavior change in behavior therapy must be complemented by recognition of the Value of acceptance, and the importance of the relationship between these tw o treatment goals. The same dialectic is central to the treatment of e ating disorders and obesity. Having made nutritionally sound and psych ologically adaptive lifestyle changes, patients need to accept whateve r shape and weight these changes produce. Treatment strategies for ove rcoming obstacles to acceptance are discussed. These include education , the use of the therapeutic relationship, and cognitive restructuring . Acceptance is an active process of self-affirmation rather than pass ive resignation to an unhappy fate. It involves emotional processing a s well as cognitive and behavioral change. The focus on acceptance and the empirical evidence on the effectiveness of cognitive behavioral t herapy (CBT) in promoting self-acceptance in patients with eating diso rders contrasts with the treatment of obesity where the value of self- acceptance has received less research attention. Aside from being impo rtant in its own right, enhancing self-acceptance might lead to more l asting changes in health-relevant eating and exercise behavior.