Body image and weight-related shame prospectively predict binge eating symptomology and weight outcomes: The value of deshaming approaches to weight management.
Background & Aims: Cross sectional associations suggest that BMI is associated with body image shame, which, in turn, is associated with negative self evaluations and loss of control of eating (binge eating symptomology) in some participants of a commercial weight management programme. Objectives: The current study investigated the prospective effect of body image shame on weight outcomes, measured as change in body mass index (BMI), considering the effect of binge eating symptoms as a mediator, over a six-month period. Material/Methods: 296 participants engaged in a commercial weight management programme completed an online survey including standardised psychometric measures of body image shame, eating attitudes and behaviours and binge eating symptoms at baseline, 3 and 6 months. Results: Results: indicated that from baseline, through to 3 and 6 months of assessment, there was a decrease in the mean scores of body image shame, binge eating symptoms and BMI. Within this period, baseline measures of body image shame significantly predicted binge eating symptoms at 3 months. Mediation analysis indicated that there was a significant prospective indirect effect of baseline body image shame, which, led to less weight loss at 6 months, and was fully mediated by binge eating symptoms measured at 3 months. The analysis controlled for the effect of BMI measures at baseline and 3 months, and baseline binge eating symptoms. Conclusion: This study supports the hypothesis that body image shame is a significant predictor of binge eating symptoms and that binge eating symptoms in turn, have an effect on extent of weight loss. Those who had greater body image related shame showed higher binge eating symptomology and lost less weight and vice versa. These findings suggest that non-stigmatic approaches that target weight-related shame may improve self-regulation of eating behaviour (decreased binge eating symptomology) and improve weight management capability in commercial weight management programmes.