Helen Egan

On the Role of Self-compassion and Self-kindness in Weight Regulation and Health Behavior Change

The construct of self-compassion has been investigated in relation to health behaviors, health behavior change, and health outcomes such as regulated eating and weight loss. Self-compassion has been defined as a mindful awareness of oneself, which involves treating oneself kindly and understanding oneself during difficult and challenging times by realizing that such experiences are common amongst all humans (Neff, 2003a). Neff (2003a,b) described how self-compassion consists of three interrelated components: self-kindness (vs. self-judgment), common humanity (vs. isolation), and mindfulness (vs. over-identification). While the psychological benefits are well documented (e.g., Neff, 2011), the health behaviors and outcomes may require more consideration, and this opinion manuscript aims to shed light on potential problems in eating and weight issues. Initial findings of self-compassion in assisting regulated eating are promising, and are explored next.

Mindful Construal Diaries: A Less Anxious, More Mindful, and More Self-Compassionate Method of Eating:

Mindful construal diaries were found to assist in weight regulation during a long-term intervention. The current study attempted to expand previous findings by testing the consideration (or priming) of questions within the diary (instead of filling in the answers), and investigated levels of state mindfulness, state self-compassion, and state anxiety in an observational trial of pre- to postintervention. Forty-five participants completed State Mindfulness, State Self-Compassion, and State Anxiety scales before and after their meal and were asked to read and consider the mindful concrete construal diary questions. The results illustrate that state mindfulness, state self-compassion, and state anxiety levels were significantly improved (i.e., increased mindfulness and self-compassion, and decreased anxiety) after participation. Findings provide further evidence as to why the diaries might work in supporting weight regulation, and suggest another method of making eating more mindful. Current findings, limitations, and recommendations for future research are discussed.

Workability and mental wellbeing among therapeutic prison officers

BACKGROUND Previous research has examined how age and health can shape workability (WA). This study seeks to explore how a lack of WA (inability) may affect the health of the employee. AIMS To explore the effects of work inability on mental wellbeing among therapeutic prison officers. METHODS An anonymous cross-sectional study of prison officers conducted in a category B English prison using the Work Ability Index (WAI) and General Health Questionnaire-28 (GHQ). RESULTS Fifty-seven officers (59%) participated and of those 95% achieved GHQ caseness. Officers with poorer WA reported significantly higher GHQ scores. Work inability for mental demands had significant associations with anxiety (β = -0.58, 95% CI -4.21 to -1.88, particularly sleep loss; Pearsons r = -0.66). CONCLUSIONS Our findings present clear associations between poor WA and its impact upon mental wellbeing. The results of this study may help to focus on areas for intervention such as improving WA and promoting mental wellbeing.

Mindfulness and mindful eating: reflections on how individuals with cystic fibrosis may benefit.

As the life expectancy of individuals with cystic fibrosis (CF) increases, so does the need to further develop psychosocial care, advice and interventions. The need to maintain optimal nutritional status has not been easy for the past decades for clinicians and individuals with CF, contributing to maladaptive nutritional intake for some people. This letter briefly suggests how research and clinical practice that incorporates mindfulness and mindful eating can improve the nutritional well-being of individuals with CF. Research with regard to generic eating experiences and behaviours within CF populations which could help us understand how eating can be improved to fully achieve the maintenance of a healthy weight is scarce. Nutritional advice derived from clinicians and dieticians is often focused on practical and useful tips (i.e. what to eat, how to prepare meals, amount of calories needed daily), and there is a general consensus that behavioural advice does increase the impact of, and adherence to, nutritional interventions. However, the empirical evidence supporting behavioural interventions is limited, and behavioural advice is somewhat contradictory. Behavioural advice in the patient information literature is by necessity generic, but also contradictory to contemporary research. For example, to enhance the appetite and consumption among CF patients, the UK CF Trust [1] suggests ‘‘limit mealtimes to about 30 min and space mealtimes 3–4 h apart.’’, while at a later segment it is suggested that people ‘‘Eat food slowly and chew food well’’ [p. 11]. Eating slowly and chewing well, and consuming a meal within 30 min may be problematic for some people. Longer meal duration was associated with nutritional barriers (such as resistance to eat more) and smaller bodies in toddlers and school-aged children [e.g. 2]. There is a wide body of evidence documenting eating difficulties in childhood, adolescence and adulthood. What is not currently well understood is whether taking a long time to eat a meal signals enjoying meals, or whether individuals may be struggling to eat the amounts required. Suggestions to prolong the meal by chewing slowly and taking your time between mouthfuls may, for people who experience difficulties, increase the levels of distress, unless it constitutes a prototype of attentive or mindful eating. There are complex issues that may be relevant to mindfulness and mindful eating. Preoccupation with food, exercise and weight are main indicators of (or diagnostic criteria for) eating disorders, but are also elements that are essentially evident and consistently observed in CF patients. For a person with CF, preoccupation with food, compulsively eating calorie-dense foods and restricting intake of other low calorie foods could be considered as adaptive and life enhancing attitudes and behaviours (rather than maladaptive). It seems reasonable to suggest that preoccupation and attentiveness to food, exercise and weight may be one method of being mindful, or may be an attentive method that entails judgement (hence, making it partially mindful or mindless) and this presents an interesting question for future research. Practising mindfulness entails experiencing the present moment, whether it is pleasant or unpleasant, with qualities of awareness, non-judgement, acceptance and compassion. So, & Michail Mantzios michael.mantzios@bcu.ac.uk

How does grazing relate to body mass index, self-compassion, mindfulness and mindful eating in a student population?:

Contemporary research investigating obesity has focused on grazing (i.e. an uncontrolled and repetitive consumption of small amounts of food). Meanwhile, constructs such as mindfulness, mindful eating and self-compassion have received much attention in assisting individuals with eating behaviours and weight regulation. The association between those constructs and grazing, however, has not been explored. In a cross-sectional study, university students (n = 261) were recruited to explore the relationship of mindfulness, mindful eating and self-compassion with current weight and grazing. Results indicated that all constructs were negatively related to grazing, but only mindful eating related negatively to current weight. In addition, mindful eating mediated the relationship between grazing and current weight. Possible explanations and future directions are discussed further with an emphasis on the need for more empirical work.

Can Existing Knowledge on Eating Behaviors and Obesity Support People with Cystic Fibrosis Who Are Nutritionally Compromised

Nutritional status is a key predictor of health outcomes and survival for individuals with Cystic Fibrosis (CF). A main concern is the maintenance of a healthy body weight by eating a high-energy and high-fat diet (Abbott et al., 2008). This diet is accompanied for most patients with pancreatic enzyme replacement therapy, and for some patients with fat soluble vitamins, oral supplements, and enteral tube feeding which further supports the high nutritional requirements (Powers et al., 2002). Nevertheless, inadequate intake in CF remains a major problem within CF populations due to a number of complex reasons including physiological factors such as anorexia or poor appetite (Durie and Pencharz, 1989), early satiety and abdominal pain (Pumariega et al., 1986). Social and psychological factors for inadequate intake in CF include feeling under pressure to eat (Abbott et al., 2008), and being afraid of choking (Murphy and Wootton, 1998). The latest Cystic Fibrosis Foundation Registry Report (2004) indicates that approximately 31% showed symptomatology consistent with malnutrition. This paper suggests possibilities for developing research further and enhancing behavioral interventions for malnourished individuals with CF. With a paucity of research on the experiences of eating in adults with CF, known information around eating in other populations should be explored. Findings in obesity research may provide useful suggestions for environmental and behavioral interventions with malnourished individuals until a healthy weight status is achieved.

Grazing, motives to eat palatable foods, and fat and sugar consumption: an exploratory investigation

PurposeContemporary research investigating obesity has focused on grazing (i.e., an uncontrolled and repetitive consumption of small amounts of food). Meanwhile, the association between grazing and motivations or actual consumption of energy-dense foods as explanatory factors has not been explored in current weight regulation research.MethodsThe association among grazing, motivations to eat palatable foods and fat and sugar consumption were explored in a cross-sectional study with university students (n = 318) who were recruited to participate in an online study.ResultsResults indicated that both motivations to eat palatable foods and fat and sugar consumption were positively related to grazing, but only motivations to eat palatable foods explained the positive relationship between grazing and current weight.ConclusionMotivations to eat palatable foods appears to be more explanatory of grazing in the sphere of weight regulation and grazing than the actual consumption of fat and sugar. Possible explanations and future directions are discussed.Level V: Opinions of respected authorities, based on clinical experience, descriptive studies or reports of expert committees.

Work–Life and Well-Being in U.K. Therapeutic Prison Officers: A Thematic Analysis:

Previous research has clearly demonstrated the positive impact of therapeutic interventions on offenders’ well-being. Much less is known about the impact on prison staff facilitating and delivering such interventions. We employed qualitative methodology to capture a deeper understanding of the work of therapeutic prison officers. Seven prison officers working in a U.K. Category B therapeutic community prison were interviewed about their working lives, including their own participation in therapy. Following a thematic analysis approach, key findings indicated that the physical and cultural work environment was very important to staff; the therapeutic element of their job role, although demanding, was both satisfying and rewarding; and that working in a therapeutic prison environment provided the opportunity for personal as well as professional development. We conclude that further attention should be given to the unique nature of therapeutic prison work and the positive impact it can have on well-being at work.

Mindfulness as an Intervention for Recalling Information from a Lecture as a Measure of Academic Performance in Higher Education: A Randomized Experiment

Higher education students experience heightened levels of stress and anxiety, and report experiencing negative thoughts and emotions, which influence information retention and recall. In a randomized experiment, we assigned participants to either a mindfulness meditation or an audiobook listening condition, and recorded the information recalled from a previously attended lecture, which was controlled for in subsequent analyses for trait resiliency and trait mindfulness. Participants placed in the mindfulness meditation condition recalled significantly more information than participants who were placed in the audiobook listening condition, even when controlling for resiliency and mindfulness. Future directions are suggested in an attempt to expand the literature and research around higher education, mindfulness and individual differences.

A Qualitative Exploration of Self-Kindness and “Treating Oneself” in Contexts of Eating, Weight Regulation and Other Health Behaviors: Implications for Mindfulness-Based Eating Programs

Background: Caring for oneself through mindfulness and compassion to improve or enhance health behaviors, and specifically eating behaviors has come to the forefront of scientific inquiry. The experiences and challenges for people in decision making around food within the context of self-kindness for body and mind care have not been previously explored. Aims: This study explored the experiences of eating behaviors in a community sample and examined the understanding of self-kindness and its relationship to eating behaviors and wellbeing of body and mind. Methods: A phenomenological theoretical position was taken; data were collected using individual semi-structured interviews. The sample was twenty-five members of the wider community in the West Midlands in England. The data were analyzed using Braun and Clarke’s (2006) procedural steps for thematic analysis. Results: Two overarching themes were inductively formulated: ‘Thinking about eating’ and ‘Caring for body and mind’. Five themes were constructed: (a) Treat food is exceptional eating, (b) The proof of the pudding is in the planning, (c) Dieting is a dirty word, which are subsumed under Thinking about eating, and (d) Self-kindness is a disavowed abstract noun, and (e) Self-kindness: A rose by any other name; under Caring for body and mind. Participants described a number of ways of treating themselves both with food and with other activities and pleasure in eating was discussed in terms of social aspects of eating rather than food. Two clear contradictions within narratives around eating and health behaviors were shown. Participants largely eschewed the concept of dieting, but described engaging in highly regulated and restrained eating. There was a lack of connection with the notion of self-kindness; although positive eating and exercise health behaviors were undertaken, they were described as necessary self-regulation, not construed as acts of self-kindness. Conclusion: The results suggests a lack of ease in the interpretation of being kind to oneself as a means of improving mental wellbeing, and an inability to relate self-kindness to physical health behaviors. The association of self-kindness with self-indulgence, and the described disconnect between hunger, satiety and pleasure in eating has implications for interpretation of mindful eating scales, practices and interventions.