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
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 & 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.

RESET

RESET
Author: Ashley Lynn Kuchar
Publisher:
Total Pages: 0
Release: 2022
Genre:
ISBN:

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Student-athletes often believe that self-criticism is necessary to avoid complacency, but this response can lead to anxiety and stress. Research shows that self-compassion is an adaptive way to cope with mistakes and adversities (see Ferrari et al., 2019; Röthlin et al., 2019 for review). Although there are many benefits of self-compassion, fear that self-compassion harms performance may discourage athletes from adopting this approach (e.g., Ferguson et al., 2015). This study developed and tested an online self-compassion intervention called Resilience and Enhancement in Sport, Exercise and Training (RESET) designed specifically for NCAA student-athletes, seeking to help athletes respond more effectively to mistakes, failures, and adversity. RESET was designed for a broader student-athlete population and is the first to adapt the Mindful Self-Compassion program (MSC; Neff & Germer, 2013) for athletes. Within-group analyses (paired t-tests) and between-group analyses (multilevel modeling) were used to assess the effectiveness of the intervention on athletes’ ability to cope with failure, improve well-being, and increase perceived sport performance. Compared to the waitlist control (n = 102, 70% women), athletes who participated in the RESET training (n = 148, 90% women) experienced significant increases in self-compassion from Time 1 to Time 2 as well as significant decreases in fear of self-compassion and state self-criticism. They also displayed improvements in perceived performance (i.e., athlete-rated performance, coach-rated performance) compared to the waitlist control. Despite observing significant improvements on well-being (reduced depression, anxiety, stress) in the within-group analyses, no statistically significant changes were found for any of the well-being measures in the between-group analyses. Notably, a main effect of gender was found for athlete-rated performance indicating that men athletes reported higher performance than women athletes. Program evaluation measures, including participant testimonials, extend the quantitative findings and demonstrate that through this accessible online intervention, student-athletes and coaches learned adaptive coping skills that are applicable to sport and other life domains. Future research should explore long-term benefits of the RESET training on various coping, well-being, and performance measures

Shame and Self-compassion in Predicting Weight Loss Maintenance and Weight Regain in Obesity

Shame and Self-compassion in Predicting Weight Loss Maintenance and Weight Regain in Obesity
Author: Kerri Michelle Bojman
Publisher:
Total Pages:
Release: 2017
Genre:
ISBN:

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Obesity is a serious health condition characterized by excess adiposity and associated with physical and mental health difficulties (Health Canada, 2003; Petry, Barry, Pietrzak, & Wagner, 2008; Tjepkema, 2006). Among individuals with obesity who successfully lose weight, most individuals are unable to sustain their weight loss over time (e.g., Kramer, Jeffrey, Forster, & Snell, 2010). Weight regain has been associated with psychological variables including weight stigmatization, depression, binge eating, and emotional eating (Ashmore, Friedman, Reichmannm & Musante, 2008; McGuire, Wing, Klem, Lang, & Hill, 1999; Konttinen et al., 2010; as cited in Kemp, Bui, & Grier, 2013; Sutin & Terracciano, 2013). Shame, an aversive emotion focused on one"s sense of self, has been strongly associated with these variables (American Psychiatric Association, 2013; Conradt, Dierk, Schlumberger, Rauh, Hebebrand, & Rief, 2007; Wong & Qian, 2016). However, the role of shame in relation to weight loss maintenance over time in a community sample of individuals with obesity has yet to be fully explored. Recently, self-compassion has been identified as being an important counterbalance to shame. Compassion-focused therapy (CFT) is based on a biopsychosocial model of affect regulation that proposes treating oneself compassionately may counteract negative feelings, such as shame, that are thought to underlie maladaptive behaviors (Gilbert, 2010). CFT interventions have been shown to decrease disordered eating behaviours, such as binge eating, in clinical samples (Gale, Gilbert, Read, & Goss, 2014). This study investigated whether compassion-focused interventions that have been found to be effective in clinical eating disordered populations may be helpful for subgroups in obese populations who struggle with high shame and unhelpful eating behaviours that interfere with weight loss maintenance. It was hypothesized that greater levels of baseline shame would predict weight regain and greater levels of self-compassion would predict weight loss maintenance. Seventy-one adults (males = 26, females = 45) who were obese and had recently lost at least 5% of their body weight through behavioural methods were recruited from the community. At baseline, six months, and twelve months, participants completed questionnaires pertaining to depression, shame, self-compassion, emotional eating, and binge eating. Participants" body mass index was also calculated at each time point. Results were opposite to initial predictions. After initial weight loss, baseline shame predicted weight loss and weight loss maintenance. Over time, this relationship weakened. Conversely, following initial weight loss self-compassion predicted weight regain. Over time, this relationship disappeared. Novel subgroups of individuals were found who reported positive effects of shame and negative effects of self-compassion on weight loss maintenance, particularly at six months. Results further indicated that baseline emotional eating played a critical role in moderating the relationship between shame and weight change, as baseline shame predicted weight regain at higher levels of emotional eating but predicted weight loss at lower levels of emotional eating. This research clarifies the roles of shame and self-compassion in relation to weight loss maintenance and weight regain over time. This study illustrated that not all individuals in the community show the same relationships between shame, self-compassion, and weight regulation. Based on these findings, future research can assess whether subgroups of individuals in obese populations who engage in high levels of emotional eating may benefit from CFT interventions for weight loss maintenance.

Multidimensional Body Image and Self-compassion

Multidimensional Body Image and Self-compassion
Author: Marissa Claire Knox
Publisher:
Total Pages: 334
Release: 2020
Genre:
ISBN:

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Negative body image has been considered a public health concern on account of its extensive contribution to mental and physical distress. Research has typically focused on negative body image and the causes, risks, and outcomes of body image concerns. More recently, positive body image has become of growing interest in the literature given the need to better understand how individuals may generate a healthful and caring view of their bodies so they may experience holistic physical and psychological wellness. Self-compassion offers an adaptive way of relating to oneself that is connected to a range of wellbeing outcomes, including healthy body image. Self-compassionate writing allows individuals to practice being kind to oneself, and research demonstrates this may be an effective tool for improving body image concerns and reducing mental and emotional difficulties. The current study examined how self-compassionate writing influenced multiple dimensions of body image, including both negative and positive body image outcomes, in college student women who self-reported having body dissatisfaction. Statistical analyses were performed using linear mixed models. Findings indicated significant increases in functionality appreciation for participants in the self-compassion writing intervention compared to participants in expressive and neutral writing conditions. No other significant group differences were observed for the other body image outcomes. Within-group analyses revealed that participants in the self-compassion intervention did have improvements in body appreciation, body compassion, and body dissatisfaction, just not significantly more than the other writing conditions. Exploratory analyses signified that women with low self-compassion experienced increases in self-compassion in the intervention condition, but not in either of the control writing conditions. Overall results suggest that writing in general is effective for enhancing body image, and self-compassionate writing in particular is beneficial for women low in self-compassion. Recommendations for a more intensive and tailored intervention are discussed

Mindful Sport Performance Enhancement

Mindful Sport Performance Enhancement
Author: Keith A. Kaufman
Publisher: American Psychological Association (APA)
Total Pages: 0
Release: 2018
Genre: Athletes
ISBN: 9781433827877

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This book is a comprehensive resource on the history, theory, and practice of mindfulness in sport. The authors present their empirically-supported, six-session mindfulness program adapted for specific athletic populations.

The Active Female

The Active Female
Author: Jacalyn J. Robert-McComb
Publisher: Springer Nature
Total Pages: 621
Release: 2023-02-27
Genre: Medical
ISBN: 3031154851

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Now in a revised and expanded third edition, the aims of The Active Female are threefold: first, to increase the awareness of wellness and fitness issues for active females and their family members; second, to provide an avenue for medical practitioners, allied health professionals, health educators/providers, and certified individuals in sports medicine/athletics to gain critical, updated knowledge of a field specific to active females; and third, to introduce the concept of obesity as a growing health concern even for normal weight individuals. Part I of the book offers a foundation for understanding the interrelationships between female physiology, body image and other psychological issues, the female reproductive cycle, and the musculoskeletal anatomy and physiology of females that makes their health risks and concerns unique. In Part II, the concepts of eating disorders from a global perspective and the health disparities and inequities in women’s health are discussed in detail. Part III describes the prevention and management of common musculoskeletal injuries in active females across the lifespan, including the management of osteoporosis. Appropriate exercise and nutritional guidelines and recommendations for active females are discussed in detail in Parts IV and V. Part VI is a new addition to the book and highlights the obesity epidemic and co-morbid diseases associated with obesity even for normal weight obese individuals. Each chapter is bookended by clear learning objectives and review questions for additional pedagogical appeal. An invaluable addition to the literature, The Active Female: Health Issues throughout the Lifespan, 3e will be of great interest to all clinicians and allied health care professionals concerned with women’s health and related issues, from sports medicine and family practitioners to endocrinologists, gynecologists and orthopedic surgeons.

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

Handbook of Positive Body Image and Embodiment

Handbook of Positive Body Image and Embodiment
Author: Niva Piran
Publisher: Oxford University Press
Total Pages: 400
Release: 2019-04-02
Genre: Psychology
ISBN: 0190841893

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For five decades, negative body image has been a major focus of study due to its association with psychological and social morbidity, including eating disorders. However, more recently the body image construct has broadened to include positive ways of living in the body, enabling greater understanding of embodied well-being, as well as protective factors and interventions to guide the prevention and treatment of eating disorders. Handbook of Positive Body Image and Embodiment is the first comprehensive, research-based resource to address the breadth of innovative theoretical concepts and related practices concerning positive ways of living in the body, including positive body image and embodiment. Presenting 37 chapters by world-renowned experts in body image and eating behaviors, this state-of-the-art collection delineates constructs of positive body image and embodiment, as well as social environments (such as families, peers, schools, media, and the Internet) and therapeutic processes that can enhance them. Constructs examined include positive embodiment, body appreciation, body functionality, body image flexibility, broad conceptualization of beauty, intuitive eating, and attuned sexuality. Also discussed are protective factors, such as environments that promote body acceptance, personal safety, diversity, and activism, and a resistant stance towards objectification, media images, and restrictive feminine ideals. The handbook also explores how therapeutic interventions (including Acceptance and Commitment Therapy, Cognitive Dissonance, and many more) and public health and policy initiatives can inform scholarly, clinical, and prevention-based work in the field of eating disorders.