Yoga at Every Size: A Preliminary Evaluation of a Brief Online Size-Inclusive Yoga and Body Gratitude Journaling Intervention to Enhance Positive Embodiment in Higher Weight College Women.

The present pilot randomized controlled trial (RCT) evaluated the feasibility, acceptability, and preliminary efficacy of a 4-week online yoga and body gratitude journaling intervention for strengthening positive embodiment among racially-diverse higher weight college women. Seventy-five participants were initially randomized to either the yoga condition (n = 36) or to a wait-list control (n = 39). Participants completed measures of positive and negative body image, weight bias internalization, self-compassion, drive for leanness, and physical activity acceptance at both baseline and post. Preliminary results among the 42 analyzed completers (mean age = 20.9, SD = 2.4; 30% Black or African American) revealed acceptable feasibility given the low-intensity nature of the intervention reflected in a 36% attrition rate. Self-reported adherence was strong for the yoga component with 81% of participants indicating that they practiced with the videos ≥3-4 times per week as suggested. Although 71% reported completing the body gratitude journal ≥1-2 times per week, daily adherence was minimal. Acceptability was also high among participants randomized to the yoga condition as indicated by 86% expressing at least moderate levels of satisfaction with the overall program. Qualitative feedback from participants further supported the acceptability of the program and pointed to important areas in further refining the protocol in the future. Preliminary efficacy was supported by significant reductions in internal body shame and gains in body appreciation, functional body appreciation, functional body satisfaction, functional body awareness, and behavioral commitment to physical activity engagement among the yoga vs. wait-list control participants. These promising findings once replicated in larger, higher-powered trials may have important implications for extending the reach and accessibility of mind-body wellness practices like yoga to benefit racially-/ethnically-diverse college women of higher weight. This research is further responsive to the growing need for efficacious remotely-delivered, and scalable behavioral health interventions in the ongoing era of the COVID-19 pandemic. However, additional research is warranted to explore ways of enhancing engagement of participants with lower levels of positive embodiment and to further incentivize the journaling component of the intervention.

Managing cancer and living meaningfully (CALM) in adults with malignant glioma: a proof-of-concept phase IIa trial.

BACKGROUND: Managing Cancer and Living Meaningfully (CALM) is an evidence-based, brief, semi-structured psychotherapy designed to help patients with advanced cancer cope with the practical and profound challenges of their illness. However, no study to date has investigated its feasibility, acceptability, and preliminary effectiveness in adults with malignant glioma, despite the well-documented incidence of psychological distress in this vulnerable and underserved population. METHODS: Fourteen patients with glioma and elevated symptoms of depression and/or death anxiety enrolled in the trial: 83% glioblastoma, 75% female, Mage = 56 years (SD = 15.1; range = 27-81). Feasibility was assessed based on established metrics. Acceptability was measured by post-session surveys and post-intervention interviews. Preliminary intervention effects were explored using paired t-tests, comparing psychological distress at baseline and post-intervention. RESULTS: Of the 14 enrolled patients, 12 were evaluable. Nine completed the study (75% retention rate). Three patients withdrew due to substantial disease progression which affected their ability to participate. Participants reported high perceived benefit, and all recommended the program to others. Baseline to post-intervention assessments indicated reductions in death anxiety, generalized anxiety, and depression, and increases in spirituality. Quality of life and fear of cancer recurrence remained stable throughout the study period. CONCLUSIONS: CALM appears feasible for use with adults with malignant glioma. Enrollment and retention rates were high and comparable to psychotherapy trials for patients with advanced cancer. High perceived benefit and reductions in symptoms of death anxiety, generalized anxiety, and depression were reported by participants. These findings are extremely encouraging and support further study of CALM in neuro-oncology. TRIAL REGISTRATION NUMBER: NCT04646213 registered on 11/27/2020.

Lessons learned from a pilot intuitive eating intervention for college women delivered through group and guided self-help: qualitative and process data.

Although disordered eating is prevalent in college women, most will not receive treatment, and existing approaches have limitations. Thus, novel and accessible approaches are warranted. However, few behavioral health interventions progress beyond initial implementation, underscoring the importance of feasibility and acceptability data to guide intervention development and refinement. Stakeholder perspectives can enrich these data, as they can highlight potential mechanisms to investigate in larger randomized-controlled trials (RCTs). The current study examined participant and leader feedback from an 8-week pilot intuitive eating (IE) intervention for college women with disordered eating delivered through group and guided self-help (GSH) modalities. Participants (N = 71) and leaders (N = 8) completed anonymous weekly surveys and exit questionnaires. Overall, the intervention was acceptable and feasible for both participants and leaders. Unique benefits of each modality, such as validation and support in group, and individualization and convenience in GSH, contributed to participant satisfaction and efficacy. Moreover, potential mechanisms of intervention effects, such as interoceptive awareness and self-compassion, were cited in both conditions, and should be explored in a future, fully-powered RCT. Areas for potential refinement include extending the intervention, assessing a hybrid treatment, online delivery, and careful design of a control condition to isolate the intervention's mechanisms of change.

A randomized control trial of Expand Your Horizon: An intervention for women with weight bias internalization.

Weight bias internalization (WBI) is associated with a myriad of negative health outcomes, but there are few effective treatments that address this concern. This randomized controlled trial examined the preliminary effectiveness of a previously developed body gratitude journaling intervention (i.e., Expand Your Horizon) compared with an active control writing condition (i.e., expressive writing) in emerging adult women with WBI. Participants (N = 135) completed baseline measures and were then randomized to either Expand Your Horizon (n = 72) or the active control condition (n = 63). Participants in both conditions completed three writing tasks over one week. Assessments occurred at baseline, post-test, and follow-up (one-week). Participants in both conditions experienced improvements in WBI, functionality appreciation, and self-compassion at follow-up, though improvements were greater in the Expand Your Horizon condition. Further, participants in the Expand Your Horizon had greater improvement in healthcare stress at follow-up. In sum, Expand Your Horizon appeared accessible and demonstrated preliminary effectiveness in a sample of emerging adult women with WBI. Avenues for future research include evaluating this intervention in more diverse populations with a longer follow-up.

Black and White women's attributions of women with underweight.

Despite the idealization of thin bodies, many people with low body weights report experiencing weight stigma. This stigma might relate to stereotypes about eating disorders (EDs). Specifically, people with lower body weights might be perceived as having EDs, conditions associated with significant stigma. Also, there is considerable pressure for Black women to obtain a curvy ideal, which could lead to anti-thin bias (i.e., the belief that individuals at lower body weights have undesirable characteristics) in this group. The current study evaluated these possibilities via an examination of anti-thin bias in Black and White women. Further, we explored perceived attributions of weight for Black and White women with underweight. Black (n = 96) and White (n = 128) participants read racially concordant vignettes in which characters varied by body mass index (BMI) status (slightly underweight, average weight, and slightly overweight). White women were more likely to ascribe negative personality characteristics to White vignette characters with underweight than to characters with average weight. In contrast, Black women's perceptions of Black vignette characters did not differ according to weight status. Both Black and White participants were more likely to attribute underweight characters' body weight to an ED compared with average weight characters. Results suggest that weight bias literature should incorporate the assessment and impact of weight stigma for individuals across the BMI spectrum.

What are you losing it for? Weight suppression motivations in undergraduates.

PURPOSE: Accumulating evidence suggests weight suppression (WS) is related to disordered eating and eating disorder (ED) risk in non-clinical samples; however, research to-date has not examined the intentionality of, or motivations for, WS. The purpose of this study was to: (1) qualitatively assess WS motivation in undergraduates, and (2) explore differences in body image and eating behaviors across motivation categories. METHODS: In the first study, responses from 192 undergraduates were evaluated using inductive content analysis; four primary motivation categories emerged: appearance, functional, sports/military, and unintentional. In a second study, 1033 undergraduates indicated their primary WS motivation, if applicable, and completed body image and eating behavior measures. Separate analyses were run by gender; covariates included current body mass index (BMI) and WS. RESULTS: Differences in body image and eating behaviors emerged across motivation categories for both men (p < 0.001) and women (p < 0.001). Appearance-motivated WS in men, and appearance and sports/military-motivated WS in women, were related to greater body dissatisfaction, restraint, thin-ideal internalization, and ED risk. Undergraduates with intentional WS demonstrated higher body dissatisfaction and eating pathology than undergraduates with unintentional or no WS (all ps < 0.05). CONCLUSIONS: Assessing weight history and WS motivations could be a brief, low-cost intervention to improve identification of undergraduates at greatest risk for EDs. This information could be integrated into campus marketing campaigns promoting wellness. LEVEL OF EVIDENCE: Cross-sectional descriptive study, Level V.

Fat is fashionable and fit: A comparative content analysis of Fatspiration and Health at Every Size® Instagram images.

In step with the proliferation of Thinspiration and Fitspiration content disseminated in popular web-based media, the fat acceptance movement has garnered heightened visibility within mainstream culture via the burgeoning Fatosphere weblog community. The present study extended previous Fatosphere research by comparing the shared and distinct strategies used to represent and motivate a fat-accepting lifestyle among 400 images sourced from Fatspiration- and Health at Every Size®-themed hashtags on Instagram. Images were systematically analyzed for the socio-demographic and body size attributes of the individuals portrayed alongside content reflecting dimensions of general fat acceptance, physical appearance pride, physical activity and health, fat shaming, and eating and weight loss-related themes. #fatspiration/#fatspo-tagged images more frequently promoted fat acceptance through fashion and beauty-related activism; #healthateverysize/#haes posts more often featured physically-active portrayals, holistic well-being, and weight stigma. Findings provide insight into the common and unique motivational factors and contradictory messages encountered in these fat-accepting social media communities.