Internalized weight stigma and intuitive eating among stressed adults during a mindful yoga intervention: associations with changes in mindfulness and self-compassion

Tosca D Braun, Kristen E Riley, Zachary J Kunicki, Lucy Finkelstein-Fox, Lisa A Conboy, Crystal L Park, Elizabeth Schifano, Ana M Abrantes, Sara W Lazar, Tosca D Braun, Kristen E Riley, Zachary J Kunicki, Lucy Finkelstein-Fox, Lisa A Conboy, Crystal L Park, Elizabeth Schifano, Ana M Abrantes, Sara W Lazar

Abstract

Purpose: Internalized weight stigma (IWS) is common in the United States of America across body weight categories, and is implicated in the development of distress and unhealthy eating behaviors (e.g. overeating, disordered eating) that can foster poor cardiometabolic health. While emerging intervention research shows early promise in reducing IWS, long-term efficacy is unclear and novel strategies remain needed. This analysis examined whether participation in a mindful yoga intervention was associated with reduced IWS and increased intuitive eating, an adaptive eating behavior, and whether these changes correlated with each other or with changes in mindfulness and self-compassion.

Methods: Participants were stressed adults with low fruit and vegetable intake (N = 78, 64.1% White, M. Body Mass Index 25.59 ± 4.45) enrolled in a parent clinical trial of a 12-week mindful yoga intervention. Validated self-report measures of IWS, intuitive eating, mindfulness, and self-compassion were administered at pre-treatment, mid-treatment (8 weeks), post-treatment (12 weeks), and 4-month follow-up (24 weeks).

Results: Linear mixed modeling revealed significant improvements in IWS and intuitive eating across the four timepoints (p < .001). Reduced IWS correlated with increased intuitive eating pre- to post-treatment (p = .01). Improved self-compassion and mindfulness correlated with intuitive eating (both p = . 04), but not IWS (p = .74 and p = .56, respectively).

Conclusion: This study offers preliminary support for the hypothesis that mindful yoga may promote intuitive eating and reduce IWS among stressed adults with poor diet, and suggests that changes in these factors may co-occur over time. Further investigation with controlled designs is necessary to better understand the temporality and causality of these relationships.Trial registration: ClinicalTrials.gov identifier: NCT02098018.

Keywords: Yoga; internalized weight bias or internalized weight stigma; intuitive eating; mindfulness; self-compassion.

Conflict of interest statement

Financial interests: Drs. Kristen E. Riley, Zachary J. Kunicki, Elizabeth Schifano, and Ana Abrantes, as well as Dr. Lucy Finkelstein, declare they have no financial interests. Through 2012, two years before the present study began, Dr. Tosca Braun was employed by the Kripalu Center for Yoga and Health, a non-profit organization that created the initial yoga program adapted for use in this study. In 2021, unrelated to this study, Dr. Braun received a speaker honorarium from Kripalu Center. Drs. Lisa Conboy, Crystal Park, and Sara Lazar have received speaker honorarium and research funding from the center for work unrelated to this study. Non-financial interests: Dr. Braun is a Kripalu-trained yoga instructor and yoga therapist. No other authors report non-financial interests.

© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Figures

Figure 1.
Figure 1.
CONSORT diagram.

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