Eating Disorders Mental Health Research

Eating disorders and the power of self-compassion

Artwork at the Provincial Adult Tertiary Eating Disorders program at St. Paul's Hospital.

February 1 to 7 is Provincial Eating Disorders Awareness Week (PEDAW), a BC-wide campaign to raise awareness around prevention and early intervention of eating disorders. In light of this week, learn more about some of the eating disorders research taking place at St. Paul’s Hospital.

Growing evidence links self-compassion with good mental and physical health.

So what exactly does it mean to have compassion for oneself? It means being mindful, recognizing our common humanity in times of hardship, and practising self-kindness in times of suffering.

Researchers at St. Paul’s Hospital are currently exploring the role of self-compassion in eating disorders treatment and recovery. One year into a five-year study, their early findings suggest that self-compassion plays a significant and beneficial role when it comes to patient outcomes.

Dr. Josie Geller
Dr. Josie Geller

“What’s really striking is that individuals who have eating disorders have barriers to practising self-compassion,” noted Dr. Josie Geller, Registered Psychologist and Director of Research with the Eating Disorders Program at St. Paul’s.

Through interviews, her team has started to identify the reasons some patients may have difficulty practising self-compassion. They’ll then use their learnings to develop an intervention that aims to break down those barriers.

Study emerged from earlier research

The Provincial Adult Tertiary Eating Disorders Program (PATSED) at St. Paul’s provides specialized care for adults 17 and older with anorexia nervosa, bulimia nervosa, and other feeding or eating disorders. Dr. Geller, a researcher with the Centre for Health Evaluation and Outcome Sciences (CHÉOS) and Associate Professor at UBC in the Department of Psychiatry, leads the research arm of the program, which is tightly integrated with clinical care.

The self-compassion study sprang from Dr. Geller’s previous research which showed that a patient’s readiness to change is the best predictor of clinical outcomes.

“It was a game-changer for us to understand the importance of readiness and motivation and to work with patients’ readiness throughout treatment,” she said. Prior to that research, there were no consistent indicators to help them understand who might benefit most from treatment, who would maintain their changes months later, and who might drop out or relapse.

Of course, becoming motivated isn’t as easy as flicking on a light switch, so the researchers wanted to explore what factors could enhance a patient’s readiness to change. That’s how they identified self-compassion, a variable shown to be beneficial for people with chronic health conditions.

The study isn’t just recruiting patients from the St. Paul’s eating disorders program – it’s also recruiting clinicians and family members. With the latter two groups, researchers will investigate how self-compassion affects their ability to participate in collaborative care. Collaborative care – when health providers use a non-judgmental stance, work with patients and their families to provide choices tailored to their readiness and needs – is critical to helping people with chronic health conditions, and particularly eating disorders patients with low motivation.

Getting the hard evidence

The study so far suggests individuals with eating disorders face barriers to self-compassion that are higher and different from people who don’t have eating disorders. One major barrier is the fear that practising self-compassion will cause the patient to lose their drive to achieve or meet standards. Emotional vulnerability, or concerns about experiencing difficult feelings, is another.

Similar to readiness, the presence of these barriers at the start of treatment is a strong predictor of outcomes. These findings don’t surprise Dr. Geller. 

“We’re researching something that, at a gut level, you kind of know. But it’s hard for us to incorporate self-compassion into treatment if we don’t have data to support it,” Dr. Geller said. “The research provides hard evidence to support its inclusion in development of interventions to benefit patients in the future.”

Like all eating disorders research conducted at St. Paul’s, this study was inspired by the experiences and questions of patients. In fact, the PATSED Patient and Family Advisory Committee was actively involved in all stages of this research. The results will contribute to a body of work that is improving care not only for eating disorders patients at St. Paul’s, but for individuals with other chronic health conditions, such as HIV/AIDS, obesity and substance use, nationally and internationally.

“We’re so lucky that we’ve always had the financial and moral support of the Mental Health Program at Providence Health Care to conduct continuous quality-improvement research here. All of the questions that we’ve looked at have had direct clinical implications,” Dr. Geller said.

“Improving Outcomes In The Treatment Of Eating Disorders: Self-Compassion In Patients, Families And Clinicians” is supported by a Michael Smith Foundation for Health Research Health Professional-Investigator Award.

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