A randomized controlled trial of an acceptance and commitment therapy-informed diabetes prevention program reduces body shame and distress.

Objective: Body shame drives psychological and behavioral precursors of Type 2 diabetes (T2D) prevention and management and may be present in conventional prevention programs. We tested the efficacy of a brief acceptance and commitment therapy (ACT)-informed T2D prevention intervention targeting those outcomes.

Method: Participants (N = 298) were at high risk for developing T2D, had not previously attended a diabetes prevention program, and were randomized to a virtual intervention grounded in ACT and diabetes education or diabetes education alone. Intervention-related body shame was the primary outcome, and several secondary outcomes were also examined.

Results: Participants in the ACT + diabetes prevention education group (vs. diabetes prevention education only) had significantly lower body shame, which was significantly related to perceptions of diabetes-related threat, diabetes distress, and perceived self-efficacy for diabetes prevention self-management, among others, and also mediated the effect of treatment on threat and anxiety.

Conclusions: This randomized controlled trial provides one of the first experimental tests of an ACT-informed diabetes prevention program that can reduce intervention-related body shame and related health and well-being outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).