Purpose: The present study aimed to determine the effectiveness of Dialectical Behavior Therapy (DBT) on integrative self-knowledge and guilt in adolescents with anorexia nervosa and low physical activity levels.

Materials and Methods: This study was applied in terms of purpose and quasi-experimental in terms of method, using a pretest–posttest–follow-up design with a control group. The statistical population consisted of adolescents with anorexia nervosa referring to the Oj Counseling Clinic in Rafsanjan, Iran,. The sample consisted of 30 participants who were selected through convenience sampling and randomly assigned to the experimental and control groups. Participants completed the Integrative Self-Knowledge Scale (Ghorbani et al.,2003) and the Guilt Inventory (Kugler & Jones, 1992) at the pretest, posttest, and follow-up stages.The DBT sessions were conducted based on the Dialectical Behavior Therapy Techniques (McKay et al.,2007) over 8 ninety-minute sessions.

Results: The results showed that DBT was effective on integrative self-knowledge and guilt in adolescents with anorexia nervosa (P<0.01), and the effects remained stable over time (P<0.01).

Conclusion: The results indicated that DBT, particularly when combined with attention to movement needs and lifestyle modification, can enhance integrative self-knowledge and reduce guilt in adolescents with anorexia nervosa and low physical activity levels. Therefore, given the key role of physical inactivity in exacerbating the symptoms of this disorder, this therapeutic approach can be utilized as a comprehensive, effective, and practical intervention in psychotherapy centers, specialized eating disorder clinics, and rehabilitation programs to take an effective step toward improving this group of patients by enhancing the mind–body relationship.