Internalized weight stigma in women with class III obesity: A randomized controlled trial of a virtual lifestyle modification intervention followed by a mindful self‐compassion intervention

Abstract

Background: Internalized weight stigma (Internalized-WS) is prevalent among individuals with severe obesity, particularly women, and is associated with shame, disordered eating, and weight gain. Effective, accessible interventions that address both severe (Class-III) obesity and Internalized-WS are needed. This randomized pilot trial evaluated the feasibility, acceptability, and preliminary efficacy of a fullyremote lifestyle modification intervention (LM) followed by mindful self-compassion training (MSC) or control. Methods: Twenty-eight women with Class-III obesity (46.6 � 3.7 kg/m 2 ) and elevated Internalized-WS were randomized to a virtually-delivered 4-month LM followed by a 2-month MSC or cooking/dietary education (CON). Psychosocial measures/weight were assessed at baseline, 4-(post-LM), 6-(post-MSC/CON), and 9-month (follow-up).Results: Improvements in Internalized-WS, shame, and self-compassion were observed with LM. Mean 4-month weight loss was 6.3 � 3.7%. MSC had lower attendance and usefulness ratings versus CON. Post-MSC/CON, MSC yielded significant and/or meaningful improvements in Internalized-WS, self-compassion, and intuitive eating relative to CON. Weight loss did not differ by group at 6-month, and at 9-month trended lower in MSC versus CON. Conclusion:Virtual LM is feasible, acceptable, and leads to significant weight loss among women with severe obesity; MSC led to further improved Internalized-WS, self-compassion, and intuitive eating. Continued work is needed to elucidate effects of self-compassion training on Internalized-WS, its mechanisms, and linkages to cardiometabolic health and long-term weight loss.

Community‐based care needs for adults with class III obesity before and after tertiary weight management: An exploratory study

“… 15 Literature has found that experiences of stigma are more prevalent among those with class 3 obesity compared to those with lower BMIs. 37 , 38 …”

“…Inherent within weight‐stigma is the assumption that patients are to blame for having obesity, and that the reversal of obesity is a matter of personal responsibility 15 . Literature has found that experiences of stigma are more prevalent among those with class 3 obesity compared to those with lower BMIs 37,38 …”

“…15 Literature has found that experiences of stigma are more prevalent among those with class 3 obesity compared to those with lower BMIs. 37,38 The stigmatization of obesity has led to widespread failure to address it as a chronic disease, contributing to many health issues experienced among individuals with obesity, such as disordered eating and depression/anxiety, as well as strong reluctance to engage with community-based services. 24,36 In efforts to mitigate the stigma in healthcare, a recent report released by an Australian consumer organization, the Weight Issues Network, has led to calls for improved understanding from providers.…”