The Effects of Self-Compassion on Internalised Weight-Based Stigma

Abstract

Weight stigma is a painful and distressing phenomenon experienced by many individuals with overweight and obesity around the world. Weight stigma, whether experienced from others, or internalised by individuals with overweight, is associated with a myriad of detrimental physical and mental health outcomes (Latner, Durso, & Mond, 2013; Papadopoulos & Brennan, 2015; Pearl, Puhl, & Dovidio, 2015; Puhl & Brownell, 2001). Given the widespread and negative impact of weight stigma, there is a need for strategies to alleviate the effects of weight stigma and assist individuals to better cope with stigmatising situations (Flint, Raisborough, & Hudson, 2020). Concurrently, there has been an increased interest in the field of self-compassion research, for which there is now compelling evidence highlighting that self-compassion is beneficial for mental health and well-being. Evidence shows that self-compassion is particularly important during times of suffering and distress, and can serve to buffer the effects of stigma for various populations, including marginalised groups (Fredrick, Williams, & LaDuke, 2019). Evidence demonstrating the advantages of self-compassion provides a persuasive rationale to argue that self-compassion has the potential to attenuate the negative effects of weight stigma. However, studies merging the fields of weight stigma and self-compassion research are limited, and the role of self-compassion within the context of weight stigma is an understudied area of investigation. Based on empirical evidence available from both fields, it is argued that self-compassion can serve as a protective factor in the lives of weight stigmatised individuals with overweight. It is further argued that a compassion focused method to alleviate the effects of weight stigma and develop the capacity for self-compassion offers an important empirical contribution to the field of weight stigma research, which has not been offered by the approaches currently available. This dissertation aimed to firstly present a review of empirical evidence across the fields of weight stigma and self-compassion. Following this, a series of studies aimed to identify and address gaps in the literature. Specifically, the research presented in this dissertation was designed to address three primary aims: 1) to investigate the role of internalised weight stigma and self-compassion in the relationship between weight stigma and outcomes of psychological distress, body shame, loneliness and life satisfaction; 2) develop a compassion-focused group intervention specifically designed to reduce the adverse effects of weight stigma; and 3) conduct a pilot study to examine the acceptability and feasibility of a compassion-focused group intervention for weight stigmatised women with overweight and obesity. This dissertation presents a compendium of three studies conducted to achieve these aims. Study 1 involved an empirical study that tested the relative contribution of both internalised weight stigma and self-compassion on weight stigma, as mediators in the relationship between weight stigma and outcomes of psychological distress, loneliness, body shame and life satisfaction. Results revealed that internalised weight stigma mediated the relationship between external weight stigma and body shame, while self-compassion mediated the relationship between external weight stigma and psychological distress, loneliness and satisfaction with life. Study 2 provided a detailed account of the development of a 2-day Compassion-Focused Therapy (CFT) intervention, designed to increase self-compassion, and reduce internalised weight stigma for women with overweight and obesity. Two case studies demonstrated improvements in the expected direction for self-compassion, internalised weight stigma, depression, body shame, loneliness, weight self-efficacy, body dissatisfaction, life satisfaction, as well as weight loss. Study 3 tested the feasibility/acceptability of the 2-day, Compassion-Focused Therapy (CFT) program for a group of weight stigmatised females with overweight and obesity in Australia. Significant group improvements were found from pre-treatment to post-treatment for self-compassion and internalised weight stigma, with gains maintained at 3-month follow-up. Significant improvements were also found for psychological distress, life satisfaction, eating self-efficacy, body dissatisfaction and loneliness at the post-treatment assessment. A non-significant trend of mean group weight loss from pre-treatment to three-month follow-up was also observed. Credibility ratings of the program were high. This compendium of research has advanced research knowledge in two main ways. Firstly, the research reported herein is the first to have demonstrated the unique roles of both self-compassion and internalised weight stigma as mechanisms through which experienced weight stigma can affect a range of adverse psychological consequences. Secondly, this dissertation has demonstrated the feasibility and acceptability of a 2-day CFT-based group program specifically designed to increase self-compassion and reduce internalised weight stigma for women with overweight and obesity. The current program has merged two important fields of self-compassion and weight stigma research, thus providing evidence for self-compassion as a promising strategy through which to assist individuals to better cope with the painful effects of weight stigma.