The Effectiveness of Mindful Self-compassion Treatment as a Compound Method with Diet Therapy on Body Mass Indexes and the External Shame in Women with High Body Mass Indexes

Document Type : Original Article


Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran


Introduction: Overweightness has been one of the most prevalent global problems during recent years. This investigation was carried out to compare the compound treatment of diet therapy and mindful self-compassion with diet therapy as a one component treatment.
Method: The current research was a quasi-experimental study with pre-test, post-test and a two-month follow-up on 40 women with high Body Mass Indexes (BMIs). The participants were selected among the women who had sought professional help in nutrition clinics of Kermanshah in 2019. Convenience sampling was applied and the 40 participants were equally divided between experimental and control groups. Both groups received diet therapy but one of them received eight sessions of mindful self-compassion in addition to the diet therapy. Data were collected using the external shame scale and by measuring the BMIs. The data were analyzed using SPSS-25.
Results: The results of repeated measures ANOVA indicated that mindful self-compassion has led to significant reductions in external shame components (except for being ashamed of making mistake), the total external shame score, and the BMI.
Conclusion: Teaching and practicing mindful self-compassion can effectively reduce external shame and the BMI. This findings highlight the importance of self-compassion in decreasing psychological problems and weight control.


  1. Tuschen-Caffier B, Vögele C, Bracht S, Hilbert A. Psychological responses to body shape exposure in patients with bulimia nervosa. Behaviour research and therapy. 2003;41(5):573-86.
  2. Dobson R, Burgess MI, Sprung VS, Irwin A, Hamer M, Jones J, et al. Metabolically healthy and unhealthy obesity: differential effects on myocardial function according to metabolic syndrome, rather than obesity. International journal of obesity. 2016;40(1):153-61.
  3. DiMarco ID, Klein DA, Clark VL, Wilson GT. The use of motivational interviewing techniques to enhance the efficacy of guided self-help behavioral weight loss treatment. Eating Behaviors. 2009;10(2):134-6.
  4. Najafi F, Pasdar Y, Hamzeh B, Rezaei S, Nazar MM, Soofi M. Measuring and decomposing socioeconomic inequalities in adult obesity in Western Iran. Journal of Preventive Medicine and Public Health. 2018;51(6):289.
  5. Rezaei S, Hajizadeh M, Khosravipour M, Khosravi F, Rezaeian S. Socioeconomic Inequalities in poor health-related quality of life in Kermanshah, Western Iran: a decomposition analysis. Journal of Research in Health Sciences. 2018;18(1):405.
  6. Iyengar NM, Gucalp A, Dannenberg AJ, Hudis CA. Obesity and cancer mechanisms: tumor microenvironment and inflammation. Journal of clinical oncology. 2016;34(35):4270.
  7. Finocchiaro G, Papadakis M, Dhutia H, Cole D, Behr ER, Tome M, et al. Obesity and sudden cardiac death in the young: Clinical and pathological insights from a large national registry. European journal of preventive cardiology. 2018;25(4):395-401.
  8. Zebardast A, Besharat MA, Pourhossein R, Bahrami EH, Poursharifi H. Compare the Efficacy of Interpersonal Therapy and Emotional Management on Weight Loss in Obese and Overweight Women. 2015.
  9. Farrokhmanesh M, Mokhtari Lakeh N, Asiri S, Kazem Nezhad Leyli E, Ghaemi A, Afzali S. A Comparative Effect of Child-to-Child and Health Educator to-Child Teaching Approaches on Nutritional Status in Elementary School Students. Journal of Holistic Nursing And Midwifery. 2018;28(2):101-8.
  10. Marta-Simões J, Ferreira C, Mendes AL. Exploring the effect of external shame on body appreciation among Portuguese young adults: The role of self-compassion. Eating behaviors. 2016;23:174-9.
  11. Matos M, Pinto-Gouveia J, Duarte C. Other as Shamer. Versão portuguesa e propriedades psicométricas de uma medida de vergonha externa [Other as Shamer: Portuguese version and psychometric properties of a measure of external shame]. Manuscript submitted for publication. 2011.
  12. Tasca GA, Szadkowski L, Illing V, Trinneer A, Grenon R, Demidenko N, et al. Adult attachment, depression, and eating disorder symptoms: The mediating role of affect regulation strategies. Personality and Individual Differences. 2009;47(6):662-7.
  13. Weber DD, Aminazdeh-Gohari S, Kofler B. Ketogenic diet in cancer therapy. Aging (Albany NY). 2018;10(2):164.
  14. Vergati M, Krasniqi E, D Monte G, Riondino S, Vallone D, Guadagni F, et al. Ketogenic diet and other dietary intervention strategies in the treatment of cancer. Current medicinal chemistry. 2017;24(12):1170-85.
  15. Amel AK, Amel SK, Erfan A. Effectiveness of parents-focused cognitive-behavioral therapy on attention deficit hyperactivity disorder symptoms, obesity and self-esteem of overweight children with attention deficient hyperactivity disorder. Advanced biomedical research. 2018;7.
  16. Rader S, Dorner TE, Schoberberger R, Wolf H. Effects of a web-based follow-up intervention on self-efficacy in obesity treatment for women. Wiener Klinische Wochenschrift. 2017;129(13-14):472-81.
  17. Barabasz M. Efficacy of hypnotherapy in the treatment of eating disorders. Intl Journal of Clinical and Experimental Hypnosis. 2007;55(3):318-35.
  18. Gilbert P. Mindful compassion: Using the power of mindfulness and compassion to transform our lives: Hachette UK; 2013.
  19. Neff KD, Germer CK. A pilot study and randomized controlled trial of the mindful self‐compassion program. Journal of clinical psychology. 2013;69(1):28-44.
  20. Albertson ER, Neff KD, Dill-Shackleford KE. Self-compassion and body dissatisfaction in women: A randomized controlled trial of a brief meditation intervention. Mindfulness. 2015;6(3):444-54.
  21. dorvei f, zoghipaydar m, yarmohammadi m, imeni b. The effect of self-compassion training based onmindfulness on the dimensions of nurses' professional quality of life. Quarterly of Clinical Psychology Studies. 2019;9(34):89-108.
  22. Goss K, Gilbert P, Allan S. An exploration of shame measures—I: The other as Shamer scale. Personality and Individual differences. 1994;17(5):713-7.
  23. foroughi A, khanjani s, KAZEMINI M, tayeri F. Factor structure and psychometric properties of Iranian version of External Shame Scale. 2015.
  24. Khalatbari J, HEMMATI SV, Mohammadi H. Effect of Compassion-Focused Therapy on Body Image and Marital Satisfaction in Women with Breast Cancer. 2018.
  25. Salimi A, Arsalandeh F, Zahrakar K, Davarniya R, Shakarami M. The effectiveness of compassion-focused therapy on mental health of women with multiple sclerosis. Horizon Med Sci. 2018;24(2):125-31.
  26. O'Reilly GA, Cook L, Spruijt‐Metz D, Black DS. Mindfulness‐based interventions for obesity‐related eating behaviours: a literature review. Obesity reviews. 2014;15(6):453-61.
  27. Tajik R, Shahed Hagh Ghadam H, Rahnejat A-M. The Effectiveness of Mindfulness-Based Cognitive Therapy in Improving Adaptive Behaviors, Quality of Life, and Self-Efficiency of Students with Mild Depression. International Journal of Behavioral Sciences. 2020;13(4):142-6.
  28. Mohammadpour M, Amiri S, Farnoodi R, Bahari A, Goodarzi G, Foroughi A. The Effectiveness of Mindfulness-based Cognitive Therapy on the Psychological Symptoms of Students with Social Anxiety Disorder: A Randomized Clinical Trial. International Journal of Behavioral Sciences. 2020;14(1):6-12.
  29. Oliveira S, Trindade IA, Ferreira C. The buffer effect of body compassion on the association between shame and body and eating difficulties. Appetite. 2018;125:118-23.
  30. Germer CK, Neff KD. Self‐compassion in clinical practice. Journal of clinical psychology. 2013;69(8):856-67.
  31. Taylor MB, Daiss S, Krietsch K. Associations among self-compassion, mindful eating, eating disorder symptomatology, and body mass index in college students. Translational Issues in Psychological Science. 2015;1(3):229.