'You can't hate yourself thin' Obesity recovery and self-compassion

Abstract

Obesity is a major public health concern in the developed, and increasingly in the developing world. One theory aimed at understanding the aetiology of obesity proposes that highly palatable foods may have addictive properties, causing a food addiction similar to other forms of drug addiction.

Kia Ākina is an obesity recovery network based on addiction treatment principles. It has been developed by the National Addiction Centre at the University of Otago in New Zealand.

Literature on obesity shows a prominence of relational concepts including relation to self. A compassionate way of relating to self is central to the concept of self-compassion. Self-compassion integrates what have been traditionally Buddhist teachings about the nature of suffering with the science of psychology. Self-compassion raising interventions have been shown to be helpful in several aspects of weight loss interventions and the concept of selfcompassion is emphasized in several aspects of the Kia Ākina network.

The current study used a mixed methods approach. The quantitative part of the study explored the following questions in quantitative analysis, using measures of participation in Kia Ākina, levels of self-compassion, and weight at baseline and six months follow up: 1) Do levels of self-compassion change throughout the recovery process? 2) Is there an association between changing levels of self-compassion, weight loss, and overall participation in the Kia Ākina network? The study found that levels of self-compassion increased significantly over the six month period that was measured. The qualitative part was an exploration of the following questions in qualitative interviews with nine members of the Kia Ākina network: 3) How do people with obesity experience their journey of recovery from obesity and what, if anything, does Kia Ākina add to this journey? 4) Do perceptions of self-compassion change during participation in Kia Ākina, and if so, how?

Qualitative analysis involved a general inductive approach within a critical realist ontology.

Analysis of the qualitative part of the study identified targets for future research aiming to improve weight loss intervention outcomes. Some of the terminology used in obesity treatment models was either embraced or rejected by the study participants, depending on attributes such as perceived stigma associated with these terms. Such conceptual interactions may be important factors in obesity treatment engagement. The concept of self-compassion was also perceived by the study participants as a different construct than that defined in the academic literature, highlighting the importance of clear communication in research and clinical practice. Additionally, the process of qualitative and quantitative assessment of self-compassion potentially contributed to the rise in self-compassion levels in this study. Consideration of the potential effects of assessment upon self-compassion levels should be considered in future research and intervention.

This research highlights a number of complexities present in obesity recovery, greater understanding of which offers hope for improving obesity treatment outcomes. Individually tailored interventions in the treatment of obesity, especially when applied in accordance with the motivational stance of the person, offer the promise of enhancing weight loss outcomes and improving support for people with obesity.