Shame and self-compassion in predicting weight loss maintenance and weight regain in obesity

Bojman, Kerri (2017) Shame and self-compassion in predicting weight loss maintenance and weight regain in obesity. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

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.

Item Type: Thesis (Doctoral (PhD))
URI: http://research.library.mun.ca/id/eprint/12977
Item ID: 12977
Additional Information: Includes bibliographical references (pages 128-152).
Keywords: Shame, Self-Compassion, Emotional Eating, Weight Loss Maintenance, Weight Regain, Obesity
Department(s): Humanities and Social Sciences, Faculty of > Psychology
Science, Faculty of > Psychology
Date: 2017
Date Type: Submission
Library of Congress Subject Heading: Obesity--Psychological aspects; Weight loss--Psychological aspects; Compulsive eating--Psychological aspects; Self-esteem

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