1. Preliminary results from KG-free: A compassionate mindfulness & acceptance group training for overweight and obese women
Palmeira, L., Pinto-Gouveia, J., Cunha, M, &Carvalho, S.
CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra
Kg-Free Training
INTRODUCTION
Obesity rates continues to grow in Western societies [1]. It is considered a pervasive chronic disease that impairs individual’s life in multiple domains: health, social and psychological [e.g., 2]. Recently interventions based on mindfulness and acceptance and commitment approaches have been receiving empirical and clinical support in several psychological and health problems, including weight management [e.g., 3, 4]. Moreover, there is growing evidence for the importance of developing strategies self-compassion as an emotional regulation strategy to decrease shame and self-criticism [e.g., 5].
T-tests
No differences were found between groups at baseline regarding age, years of education, BMI and social economical status.
Pre to post-test differences
No significant pre to post-test differences were found in the WL group. Table 1 presents the pre to post-test results found for Kg-Free group.
Includes 10 weekly group sessions plus 2 booster fortnightly sessions.
Specifically targets weight stigma, weight-related experiential avoidance patterns, shame and self-criticism;
Aims to develop emotion regulation competencies based on acceptance, mindfulness and self-compassion towards eating and weight difficulties to increase participant’s well being and Quality-of-Life.
Table 1.
Pre to post-test differences on all variables scores using Wilcoxon signed-rank test for the Kg-Free group (n = 19)
Pre-intervention Median
Post -intervention Median
Z statistic p r
BMI
34.90
-2.296
.022
.53
EDE-Q-Total
2.42
1.80
-2.461
.014
.56
EDE-Q_Dietary Restrain
1.20
2.00
-1.481
.139 na
EDE-Q_Eating Concern
1.60
.80
-3.015
.003
.69
EDE-Q_Shape Concern
4.25
2.75
-2.229
.026
.51
EDE-Q_Weight Concern
3.50
2.60
-3.118
.002
.72
TEFQ_cognitive restraint
3.00
2.83
-1.765
.078
TEFQ_uncontrolled eating
2.22
2.33
-1.309
.190
TEFQ_emotional eating
1.83
2.67
-2.640
.008
.61
AAQ_Weight
108.00
79.00
-3.502
<.001
OAS
24.00
18.00
-1.897
.058
ORWELL-Total
64.00
52.00
-2.636
.60
WSSQ - Self-devaluation
21.00
19.00
-2.685
.007
.62
WSSQ - Fear of enacted stigma
17.00
-2.390
.017
.55
Inadequate Self
-2.596
.009
Hated self
5.00
-3.226
.001
.74
Reassured Self
-.536
.592
ETAP active
16.00
-2.143
.032
.49
ETAP relaxed
11.00
-.524
.600
ETAP safe
7.00
8.00
-1.963
.050
.45
DASS_depression
4.00
-2.666
DASS_anxiety
1.00
-2.026
.043
.46
DASS_stress
6.00
-1.566
.117
Subjective Hapiness
AIM
Analyse the preliminary results from KG-Free: a compassionate mindfulness and acceptance group training for overweight and obese women without binge-eating.
METHODS AND MATERIALS
Participants (N= 41) were randomly assigned to two conditions: KG-free (n = 19) and waiting list (WL; n= 22);
Mean age of (SD = 8.63) and a mean of years of education (SD = 3.18) ;
At baseline BMI ranged from 26 to (M = ; SD = 5.15);
Measures
Eating Disorders Examination-Questionnaire (EDE-Q; Fairburn & Beglin, 1994);
Three Factor Eating Questionnaire- R21 (TFEQ-R21; )
Acceptance and Action Questionnaire –Weigh (AAQ-W; Lillis & Hayes, 2008);
Weight self-stigma Questionnaire (WSSQ; Lillis, Luoma, Levin, & Hayes, 2010)
Depression, Anxiety and Stress scale (DASS-21; Lovibond & Lovibond, 1995);
Forms of Self-Criticism and Self-reassuring Scale (FSCRS; Gilbert, Clark, Hempel, Miles, & Irons, 2004);
Obesity-related Quality of life (ORWELL-97; Mannucci, et al., 1999);
Types of Positive Affect Scale (TPAS; Gilbert, 2007)
Other as Shamer Scale (OAS; Goss & Allan, 1996);
Subjective happiness Scale (SHS, Lyubomirsky & Lepper, 1999).
Program’s Sessions 1
Introduction, group’s rules and Creative hopelessness 2
Psycho-education I: Eating and evolution 3
Psycho-education II: The role of emotions 4
My Valued Life 5
Control vs Acceptance and Defusion 6
Acceptance and Distress Tolerance 7
The Evaluations Trap 8
Shame and self-criticism 9
Fostering a compassionate mind 10
The Compassionate Letter 11
Changing what I can and Accepting what can not be changed 12
Towards a Valued Life: Relapse prevention
DISCUSSION
Results showed that at the end of the training participants from the Kg-Free group presented decreased levels of disordered eating attitudes and behaviors, less depressive and anxiety symptoms, diminished inadequate and hated self, weight stigma, weight psychological inflexibility, increased weight-related quality of life and positive affect. Also, participants from Kg-free revealed a significant weight loss. Additionally, all significant differences reflected large effect sizes. In contrast, no differences were found for the WL group.
Although still preliminary, these findings highlight the importance of implementing psychological interventions with obese patients that focus on decreasing weight stigma, self-criticism and shame and develop more adaptive emotional regulation strategies based on acceptance, mindfulness and self-compassion and increase Quality-of-Life
RESULTS
Analytical Strategy
Independent samples T-tests were conducted to assess group differences at baseline. Pre to post-test differences in both groups were assessed using the Wilcoxon signed-rank test. Additionally, r effect size were calculated to evaluate the magnitude of the effect.
REFERENCES
World Health Organization. (2011). World Health statistics. France: WHO. ISBN
World Health Organization. (2010). Global status report on noncommunicable diseases. Geneve: WHO. ISBN:
Lillis, J., Hayes, S. C., Bunting, K., & Masuda, A. (2009). Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model. Annual Behavior Medicine, 37, Doi: 10/1007/s x.
Tapper, K., Shaw, C., Ilsley, J., Hill, A., Bond, F. W. & Moore L. (2009). Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite, 52, Doi: /j.appet
Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13, 353–379. Doi: /cpp.507.