Impacts of a Brief Self-compassion Intervention for Women with Obesity and Internalized Weight Bias: Preliminary Findings from a Pilot Randomized Controlled Trial

Impacts of a Brief Self-compassion Intervention for Women with Obesity and Internalized Weight Bias: Preliminary Findings from a Pilot Randomized Controlled Trial
Author: Erin Haley
Publisher:
Total Pages: 0
Release: 2022
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ISBN:

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Internalization of weight bias occurs when one believes negative weight-related stereotypes to be true of themselves, such as believing that one is deserving of disrespect, or unworthy of partnership due to weight status (Durso & Latner, 2008). The deleterious consequences of IWB are widespread, as higher levels of IWB are associated with poor body image, maladaptive eating patterns, less physical activity, psychological distress, and less improvement in healthy lifestyle interventions (Mensinger et al., 2016; Pearl & Puhl, 2018). Further, IWB has been shown to uniquely contribute to harmful outcomes, above and beyond other risk factors such as body mass index alone (BMI; Durso & Latner, 2008). Thus, IWB represents an important target for intervention. Women have been shown to endorse higher levels of IWB relative to men and may be at greater risk for harmful consequences due to additional sociocultural factors (Fredrickson & Roberts, 1997; Himmelstein et al., 2017; Moradi & Huang, 2008). For women with obesity, the shame of not living up to a pervasive societal ideal for a woman's body, culminated with the widespread impacts of weight stigma, may increase the need for protective factors in this population (Moradi & Huang, 2008; Tylka & Hill, 2004). While there is growing empirical support for the benefits of psychological approaches for reducing IWB and associated sequalae, there is still a need for interventions that are accessible, inclusive, and relevant for a range of women (Pearl & Puhl, 2018). Many of IWB intervention studies lack diversity in their participant sample (e.g., Levin et al., 2018; Lillis et al., 2009). This not only limits the generalizability of findings but neglects the importance of developing interventions that are inclusive and relevant to different lived experiences of internalized weight bias associated impacts (i.e., Himmelstein et al., 2017). Self-compassion -- relating to oneself with a sense of kindness and support, may be a viable treatment approach for this population (Forbes & Donovan, 2019; Neff, 2003a). Self-compassion has been shown to protect against risk factors for poor body image, is inversely related to IWB, and is related to better psychological well-being overall (i.e., Braun et al., 2016; Hilbert et al., 2015; Webb & Hardin, 2016). The efficacy of self-compassion interventions for improving body image and weight-related behaviors (i.e., eating behaviors) has garnered preliminary support, and self-compassion has been a component of a few successful IWB interventions (Levin et al., 2018; Rahimi-Ardabili et al., 2018; Palmeira et al., 2017a). Thus, self-compassion interventions may hold promise for reducing IWB, and enhancing health and well-being for women with obesity and IWB. Parallel to many IWB intervention samples, however, many self-compassion interventions for weight-related and body image concerns lack racial/ethnic diversity and representation in their sample (e.g., Albertson et al., 2015). Therefore, the aim of the current study is to investigate the feasibility, acceptability, and preliminary efficacy of a three-session self-compassion intervention for women with overweight/obesity and IWB, and to assess the inclusivity and relevancy of the intervention with an emphasis on feedback from women of color (WOC). A randomized, waitlist-controlled design was implemented to evaluate the impacts of the second iteration of a self-compassion intervention tailored to IWB. This was an extension of a single group, pre-post design pilot study examining the feasibility and short-term impacts of a general self-compassion intervention for women with overweight/obesity and IWB. In the current study, feasibility and acceptability were examined through recruitment, attendance, retention, and evaluation data. Repeated measures ANCOVA were employed to examine between group differences in pre-post changes in self-compassion, IWB, body shame, body surveillance, body appreciation, intuitive eating, uncontrolled and emotional eating, and affect following the intervention. Participants included 18 women (comprised of ECU faculty/staff, students, and Pitt County, NC residents) with overweight/obesity and IWB. In terms of acceptability, participants perceived the program to be moderately beneficial for improving both self-image and well-being. Regarding assessment of inclusivity and relevancy, White and Latina participants evaluated the program to be extremely inclusive and relevant, whereas an Asian American participant rated the program to be moderately inclusive and moderately to extremely relevant, and a Black participant rated the program to be neither inclusive/exclusive or relevant/irrelevant in terms of in session content and assigned home practices, and moderately inclusive and relevant for facilitator instruction and overall inclusivity and relevancy. Regarding preliminary efficacy, participants in the self-compassion intervention (n = 10) reported significantly greater pre-post increases in self-compassion, decreases in IWB, and decreases in body shame with large effect sizes compared to the waitlist control group. Additionally, paired samples t-tests revealed significant within-group decreases in IWB, body shame, body surveillance, emotional and uncontrolled eating, negative affect, and increases in physical activity with medium to large effect sizes in the self-compassion condition following the intervention, whereas there were no within-group changes in the waitlist-controlled group. Additionally, many of the pre-post changes were maintained one month following the intervention for the self-compassion intervention participants. Overall, preliminary findings from the current pilot study suggest that brief self-compassion training tailored to IWB is feasible, acceptable, and may be beneficial for reducing IWB and associated sequalae in this population of women. Further, from this small sample, the intervention was less inclusive and relevant for Black and Asian American participants relative to White and Latina participants0́4and therefore suggests a need for enhancing these aspects of the intervention in subsequent iterations. Ultimately, development of culturally inclusive self-compassion interventions for women with obesity/IWB is a valuable avenue to for continued research to support the health and well-being of a range of women negatively affected by IWB.

IMPACTS OF A BRIEF, PILOT SELF-COMPASSION PROGRAM FOR WOMEN WITH OVERWEIGHT/OBESITY AND INTERNALIZED WEIGHT BIAS.

IMPACTS OF A BRIEF, PILOT SELF-COMPASSION PROGRAM FOR WOMEN WITH OVERWEIGHT/OBESITY AND INTERNALIZED WEIGHT BIAS.
Author: Erin Haley
Publisher:
Total Pages: 89
Release: 2020
Genre:
ISBN:

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Internalization of weight bias occurs when one believes negative weight-related stereotypes to be true of themselves, such as believing that one is deserving of disrespect, or unworthy of partnership due to weight status (Durso [and] Latner, 2008). Higher levels of internalized weight bias (IWB) are strongly associated with a range of negative consequences, such as lower health-related quality of life (Latner, Barile, Durso, [and] O'Brien, 2014), maladaptive eating patterns, lower self-esteem, body image concerns, and greater psychopathology (i.e., stress, anxiety, and depressive symptoms), and has been shown to uniquely contribute to harmful outcomes, above and beyond other risk factors such as body mass index (BMI; Durso [and] Latner, 2008). Women who are overweight may be at greater risk for harmful consequences due to additional sociocultural factors (Fredrickson [and] Roberts, 1997; Moradi [and] Huang, 2008). The shame of not living up to a pervasive societal ideal for a woman's body, culminated with the widespread impacts of weight stigma, may increase the importance for identifying and fostering protective factors in this population (Moradi [and] Huang, 2008; Tylka [and] Hill, 2004). Although the importance of reducing IWB has been well documented for improving the well-being of individuals with overweight and obesity (e.g., Tylka et al., 2014), effective interventions for reducing IWB and associated variables are limited. Self-compassion may be a valuable psychological resource that may protect against the impacts of weight stigma, and may be especially important for women with overweight/obesity and IWB (Hilbert et al., 2015; Webb [and] Hardin, 2016). Therefore, a brief, 3-week self-compassion intervention, which was modeled after an existing intervention piloted with college women (Smeets et al., 2014), was implemented to examine the potential impacts of self-compassion training in this population. Specifically, the domains of IWB, self-compassion, body image, eating behavior, and psychological symptoms were explored. Participants included 13 women (comprised of both faculty/staff and students) with overweight/obesity and high IWB. Paired samples t-tests were employed to examine changes in self-compassion, IWB, body image shame, body appreciation, intuitive eating, uncontrolled and emotional eating, and psychological symptoms following the intervention. Intuitive eating and body appreciation scores increased significantly with large effect sizes following the intervention. While not statistically significant, self-compassion increased, and uncontrolled and emotional eating decreased with small to medium effect sizes. Further, 100% of participants indicated they would recommend the program to other women who struggle with weight/self-image. Findings from this pilot intervention study demonstrated that women with overweight/obesity and IWB reported improvements in domains of functioning associated with IWB- such as eating behavior and body image, following a brief self-compassion intervention. Results suggest that self-compassion practices may hold promise for increasing body appreciation and adaptive eating behaviors in a population of women who may be especially vulnerable to consequences associated with weight stigma/IWB.

Mindfulness for the Next Generation

Mindfulness for the Next Generation
Author: Holly Rogers
Publisher: Oxford University Press
Total Pages: 193
Release: 2019-10-07
Genre: Psychology
ISBN: 0190905174

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College students and other young adults today experience high levels of stress as they pursue personal, educational, and career goals. These struggles can have serious consequences, and may increase the risk of psychological distress and mental illness among the age group now commonly referred to as "emerging adults." Scientific research has shown that practicing mindfulness can help manage stress and enhance quality of life, but traditional methods of teaching mindfulness and meditation may not be effective for college-age adults. This fully updated second edition of Mindfulness for the Next Generation describes an evidence-based approach for teaching the useful and important skill of mindfulness to emerging adults. The manualized, four-session program outlined here, Koru Mindfulness, is designed to help young adults navigate challenging tasks, and achieve meaningful personal growth. Rogers and Maytan, psychiatrists and developers of Koru Mindfulness, also discuss the unique stressors emerging adults face, identify effective teaching techniques for working with them, and review the now-robust research supporting mindfulness for stress reduction in a scientifically rigorous yet reader-friendly way. Among the features new to this edition are new data on the effectiveness of the curriculum, an introduction to the Koru mindfulness teacher certification program, and adaptations for culturally informed practice, reflecting the international appeal of Koru Mindfulness as well as its growing use outside of college settings, and extensively revised in-session scripts. Mindfulness for the Next Generation is written for therapists, teachers, health professionals, and student service providers.

Weight Bias

Weight Bias
Author: Kelly D. Brownell
Publisher: Guilford Press
Total Pages: 320
Release: 2005-08-24
Genre: Psychology
ISBN: 9781593851996

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Discrimination based on body shape and size remains commonplace in today's society. This important volume explores the nature, causes, and consequences of weight bias and presents a range of approaches to combat it. Leading psychologists, health professionals, attorneys, and advocates cover such critical topics as the barriers facing obese adults and children in health care, work, and school settings; how to conceptualize and measure weight-related stigmatization; theories on how stigma develops; the impact on self-esteem and health, quite apart from the physiological effects of obesity; and strategies for reducing prejudice and bringing about systemic change.

The Diet Trap

The Diet Trap
Author: Jason Lillis
Publisher: New Harbinger Publications
Total Pages: 192
Release: 2014-02-02
Genre: Health & Fitness
ISBN: 1608827119

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Have you tried every diet or weight loss plan under the sun, but still can’t manage to lose weight and keep it off? You aren’t alone. Each year, Americans spend billions of dollars on weight-loss products, yet we continue to have the highest obesity rate in the world. After trying and failing countless times, you have to begin to wonder, “What am I doing wrong?” The problem with most fad diets is that they only attack the symptom of the problem, not the cause. No matter how much you try to deny yourself the food you crave, you always end up reverting back to bad habits. You might even lose weight initially, but more often than not you’ll gain it back—with a couple extra pounds to boot! In order to make real change in your life, you need to change the way you think about food, weight, and what’s most important to you. The Diet Trap offers proven-effective methods based in acceptance and commitment therapy (ACT) to help you develop mindful eating habits, self-compassion, and a greater understanding of what it means to live a valued life. ACT is a values-based therapy that has been proven effective for the treatment of weight loss. Because ACT encourages you to accept and experience uncomfortable emotions—rather than succumb to emotional eating—it helps you to stay on your path to lose weight, while also helping you develop compassion toward yourself, no matter how much you weigh. Written by two researchers in the field of ACT, this book offers evidence-based solutions to help you fundamentally change the way you think about food, so that you can successfully lose weight, get healthy, and live a happy, fulfilling life without costly and frustrating fad diets.

The Wiley Handbook of Eating Disorders

The Wiley Handbook of Eating Disorders
Author: Linda Smolak
Publisher: John Wiley & Sons
Total Pages: 1027
Release: 2015-09-08
Genre: Psychology
ISBN: 1118573943

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This groundbreaking two-volume handbook provides a comprehensive collection of evidence-based analyses of the causes, treatment, and prevention of eating disorders. A two-volume handbook featuring contributions from an international group of experts, and edited by two of the leading authorities on eating disorders and body image research Presents comprehensive coverage of eating disorders, including their history, etiological factors, diagnosis, assessment, prevention, and treatment Tackles controversies and previously unanswered questions in the field Includes coverage of DSM-5 and suggestions for further research at the end of each chapter 2 Volumes

Intuitive Eating, 2nd Edition

Intuitive Eating, 2nd Edition
Author: Evelyn Tribole, M.S., R.D.
Publisher: St. Martin's Griffin
Total Pages: 305
Release: 2007-04-01
Genre: Health & Fitness
ISBN: 1429909692

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We've all been there-angry with ourselves for overeating, for our lack of willpower, for failing at yet another diet that was supposed to be the last one. But the problem is not you, it's that dieting, with its emphasis on rules and regulations, has stopped you from listening to your body. Written by two prominent nutritionists, Intuitive Eating focuses on nurturing your body rather than starving it, encourages natural weight loss, and helps you find the weight you were meant to be. Learn: *How to reject diet mentality forever *How our three Eating Personalities define our eating difficulties *How to feel your feelings without using food *How to honor hunger and feel fullness *How to follow the ten principles of Intuitive Eating, step-by-step *How to achieve a new and safe relationship with food and, ultimately, your body With much more compassionate, thoughtful advice on satisfying, healthy living, this newly revised edition also includes a chapter on how the Intuitive Eating philosophy can be a safe and effective model on the path to recovery from an eating disorder.

Parenting Matters

Parenting Matters
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 525
Release: 2016-11-21
Genre: Social Science
ISBN: 0309388570

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Decades of research have demonstrated that the parent-child dyad and the environment of the familyâ€"which includes all primary caregiversâ€"are at the foundation of children's well- being and healthy development. From birth, children are learning and rely on parents and the other caregivers in their lives to protect and care for them. The impact of parents may never be greater than during the earliest years of life, when a child's brain is rapidly developing and when nearly all of her or his experiences are created and shaped by parents and the family environment. Parents help children build and refine their knowledge and skills, charting a trajectory for their health and well-being during childhood and beyond. The experience of parenting also impacts parents themselves. For instance, parenting can enrich and give focus to parents' lives; generate stress or calm; and create any number of emotions, including feelings of happiness, sadness, fulfillment, and anger. Parenting of young children today takes place in the context of significant ongoing developments. These include: a rapidly growing body of science on early childhood, increases in funding for programs and services for families, changing demographics of the U.S. population, and greater diversity of family structure. Additionally, parenting is increasingly being shaped by technology and increased access to information about parenting. Parenting Matters identifies parenting knowledge, attitudes, and practices associated with positive developmental outcomes in children ages 0-8; universal/preventive and targeted strategies used in a variety of settings that have been effective with parents of young children and that support the identified knowledge, attitudes, and practices; and barriers to and facilitators for parents' use of practices that lead to healthy child outcomes as well as their participation in effective programs and services. This report makes recommendations directed at an array of stakeholders, for promoting the wide-scale adoption of effective programs and services for parents and on areas that warrant further research to inform policy and practice. It is meant to serve as a roadmap for the future of parenting policy, research, and practice in the United States.

Examination of a Brief, Self-Paced Online Self-Compassion Intervention Targeting Intuitive Eating and Body Image Outcomes Among Men and Women

Examination of a Brief, Self-Paced Online Self-Compassion Intervention Targeting Intuitive Eating and Body Image Outcomes Among Men and Women
Author: Reid Hlavka
Publisher:
Total Pages: 210
Release: 2021
Genre:
ISBN:

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Ideals for appearance and body image are pervasive in Western culture in which men and women are portrayed with unrealistic and often unattainable standards (Ferguson, 2013; Martin, 2010). Exposure and reinforcement have created a culture of social acceptance and internalization of these ideals, contributing to pervasive body image disturbance (i.e., body dissatisfaction; Fallon et al., 2014; Stice, 2001; Thompson & Stice, 2001; Thompson et al., 1999). Research has suggested that body dissatisfaction is expressed differently across sexes (Grossbard et al., 2008), with attention to thin ideals among women and muscular ideals among men. Body dissatisfaction has been linked to numerous poor outcomes, including dieting, unhealthy weight control behaviors, disordered eating, and increased psychopathology. Although dieting is one of the primary mechanisms employed to reduce body dissatisfaction (Thompson & Stice, 2001), research has shown that such efforts are contraindicated as dieting predicts weight gain over time (Pietil©Þinen et al., 2012) as well as preoccupation with food, disordered eating, eating disorders, emotional distress, and higher body dissatisfaction (Grabe et al., 2007; Johnson & Wardle, 2005; Neumark- Sztianer et al., 2006; Paxton et al., 2006; Tiggemann, 2005). Restrictive dietary behaviors suppress physiological cues to eat (e.g., hunger) that presents a vulnerability to eating in response to alternative cues, both internal (e.g., emotions) and external (e.g., availability of food). Intuitive eating is a non-restrictive approach to eating that encourages adherence to internal physiological cues to indicate when, what, and how much to eat (Tylka, 2006) and has demonstrated an inverse relationship with disordered eating, restrained eating, food preoccupation, dieting, body dissatisfaction, and negative affect (Bruce & Ricciardelli, 2016). Self-compassion, relating to oneself in a caring and supportive manner (Neff, 2003a), has been proposed as a pathway to increase intuitive eating and reduce body dissatisfaction (Neff & Knox, 2017; Schoenefeld & Webb, 2013; Webb & Hardin, 2016). Research has highlighted the efficacy of self-compassion interventions in addressing weight-related concerns (Rahimi-Ardabili et al., 2018) as well as brief experiential exercises for reducing body dissatisfaction (Moffitt et al., 2018). Additionally, there is a growing body of evidence supporting the efficacy of internet-based self-compassion interventions (Mak et al., 2018; Kelman et al., 2018; Nadeau et al., 2020). The purpose of the current study was to examine the effectiveness of a brief, self-paced online self-compassion intervention targeting body image and adaptive eating behaviors and potential mechanisms of change (e.g., self-compassion and psychological flexibility) among undergraduate men and women. This study also examined outcomes among men and women in the area of self-compassion, body dissatisfaction, and intuitive eating as research has highlighted the need to determine who benefits more from self-compassion interventions (Rahimi-Ardabili et al., 2018). The study compared a one-hour, self-guided online self-compassion intervention to an active control condition. The intervention was comprised of psychoeducation, experiential exercises, and mindfulness practice designed to increase self-compassion surrounding body image and eating behaviors. In contrast, the active control condition consisted of self-care recommendations and self-assessments for nutrition, exercise, and sleep. The study was administered over three parts (e.g., baseline, intervention, and follow-up) in which variables of interest were assessed at each time point. Outcome variables included self-compassion, intuitive eating, disordered eating, body appreciation, muscle dysmorphia, internalized weight bias, fear of self-compassion, and psychological inflexibility. Participants were randomized on a 2:1 intervention to control ratio at the second time point in order to make comparisons between groups while simultaneously having sufficient power for examining mediation and moderation within the treatment condition. Overall, 1023 individuals (64% women, Mage = 18.9, 67.4% white) signed informed consent and participated in at least one part of the study whereas 101 participants (71% women, Mage = 19.3, 71% white) completed all three study portions. As predicted, self-compassion was correlated with all variables of interest, and all study variables were correlated with each other (p