Effectiveness of the Combination of Schema Therapy and ACT in the Treatment of Compulsive Overeating in Clinical Practice

Objective Schema therapy (ST) and acceptance and commitment therapy (ACT) have been shown to be effective in treating eating disorders, including compulsive overeating, but evidence for the effectiveness of their combined use remains insufficient. This study evaluated the effectiveness of ST, ACT, and their combination in reducing compulsive overeating symptoms. Methods This 12-week randomised controlled trial included 100 participants diagnosed with compulsive overeating, divided into four groups. Outcomes were assessed by questionnaires at baseline, post-treatment, and at 3 and 6 months. Results All active psychotherapeutic interventions demonstrated effectiveness, but the most pronounced and persistent changes occurred in the combination therapy group. After 12 weeks, average episode frequency decreased to 1.6 in the ST group, 1.5 in the ACT group, and 0.9 in the combination group, compared to 2.8 in the control group ( P < 0.001). Compulsive overeating scores declined from a baseline of 27.0 to 21.0, 20.5, and 17.2 respectively, while the control group remained at 25.9. Follow-ups at 3 and 6 months confirmed sustained effects, with the combined group meeting remission criteria. Conclusions The combination of SC and ACT produced stronger, more durable reductions in episode frequency, symptom severity, and key psychological mechanisms than did either treatment alone. The integration of these two treatments represents a promising approach for addressing compulsive overeating in clinical practice.