The impact of cognitive restructuring and self-compassion strategies on negative body image among women with higher body weight: an experimental investigation

Individuals with higher body weight are at a greater risk of having negative body image (Friedman & Brownell, 1995). Yet current body image interventions, such as Cognitive Behavioural Therapy (CBT), are largely tested with individuals with normal weight or individuals with eating disorders. Furthermore, cognitive restructuring, one of the key components of CBT for body image (Alleva et al., 2015), relies on the assumption that negative cognitions or appraisals regarding the body are unbalanced or distorted in some way. However, people with higher body weight are 50% more likely to experience major discrimination based on their weight status and thus may possess some “evidence” from lived experience of weight bias that would lend support to their negative body-related thoughts (Puhl & Brownell, 2001; 2006). The use of compassion-focused approaches might be particularly helpful in overcoming these obstacles. Self-compassion refers to the capacity for mindfully reflecting on one’s own perceived flaws, mistakes, or wrongdoings with kindness and with an appreciation for the inherent imperfection in everyone (Neff, 2013). The present study tested the impact of various thinking strategies for managing negative body image in women with higher body weight after getting on the scale, a commonly distressing body image trigger (Ogden & Evans, 1996). Participants (N = 79) were recruited from the community and screened for moderate body dissatisfaction. They were randomly assigned to receive a single training session in cognitive restructuring (CR), self-compassion (SC), or distraction (Control) strategies after being weighed. Participants in all three of the groups reported improvements in body dissatisfaction and negative affect immediately following the training. Relative to those in the Control group, those participants who received training in CR or SC strategies reported greater improvements in body image, body image flexibility, self-compassion, and cognitive distortions one week after the training. These findings suggest that CR and SC strategies may be helpful in improving the distress associated with being weighed among women with higher body weight. The results may have broader implications for the development of psychosocial interventions focused on improving body image among these individuals.