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Category: Project

Description: Background Severe obesity (defined as a BMI ≥40 kg m-2) is often accompanied by significant mental health co-morbidities such as eating disorders and depressive disorder and people living with severe obesity often experience feelings of shame, self-criticism and feelings of inferiority in relation to others. Compassion Focused Therapy (CFT) was specifically designed for people with high levels of shame and self-criticism and aims to promote self-compassion which is regarded as an adaptive emotional regulation strategy. Aims This study aimed to explore the effect on psychological outcomes of a 10-session (weekly for 2 hours) in-person, group-based Compassion Focused Therapy (CFT) intervention for people living with severe obesity. Specifically, we sought to determine whether CFT would lead to improved self-compassion (primary outcome), depressive symptoms, emotional eating, shame, self-criticism, submissive behaviour, and negative social comparison. Method A single-centre, randomized controlled trial (RCT) was carried out with 91 participants allocated to either ‘treatment as usual’ (n=46) or ‘treatment as usual with additional group based CFT’ (n=45). Treatment as usual included dietary advice, assessment by a Consultant Endocrinologist with possible prescription of medication, and as participation in an eight-week lifestyle modification programme. Psychological outcomes were recorded at three time points (pre-treatment, post-treatment, and three-months after the end of group based CFT). Results CFT led to significant improvements in self-compassion (η2 = 0.66 at post-treatment and 0.49 at follow-up), mood, shame, emotional eating, self-criticism, social comparison, and submissive behaviour (all p<0.001) compared with treatment as usual. These results were maintained at three-month follow-up. Effect sizes for the secondary outcomes ranged from 0.3 to 0.52 at post-treatment and 0.20 to 0.45 at follow-up. Conclusions Group Compassion Focused Therapy appears to be an effective psychological intervention to alleviate psychological distress in people living with severe obesity. Trial registration number: NCT03249441.