A meta‐analysis of disordered eating and its association with self‐criticism and self‐compassion

Abstract

ObjectiveFuture treatments for eating disorders (ED) need to be enhanced by targeting maintaining mechanisms. Literature suggests self‐criticism and self‐critical perfectionism act as key mechanisms exacerbating ED, and self‐compassion protects against self‐criticism. This meta‐analysis examines associations between self‐criticism and self‐critical perfectionism on disordered eating (DE), and reviews how self‐compassion and self‐criticism relate to each other with respect to DE.MethodSearches across three databases yielded 135 studies across 42,952 participants. Heterogeneity, publication bias, and quality assessments were analyzed. Moderation analyses between self‐criticism measures, self‐compassion measures, between clinical and nonclinical samples, and between cross‐sectional and experimental studies were also conducted.ResultsRandom‐effects models showed a medium positive link between self‐criticism and DE (r = .37), and 10 subgroups pertaining to various measures of self‐criticism utilized in literature showed small to large positive links with DE (r = .20–.52). Preliminary evidence also suggests negative relationships between self‐compassion and DE (r = −.40 to −.43) and negative relationships between self‐compassion and self‐criticism (r = −.04 to −.88).DiscussionGreater levels of self‐criticism is linked with greater levels of DE and reduced levels of self‐compassion, suggesting a need to tackle self‐criticism and nurture self‐compassion in standard treatments for ED. Understanding these interactions better in conjunction with dismantling intervention studies can help develop more effective and efficient interventions targeting self‐criticism and self‐compassion for people with DE.Public Significance StatementHigher levels of self‐criticism are linked with higher levels of DE and lower self‐compassion. Self‐compassion interventions could be more effective and efficient in reducing ED symptoms if self‐criticism is tackled early in such treatments.

A call to action for more rigorous research on compassion‐focused interventions for eating disorders: Commentary on Paranjothy and Wade (2024)

“…From 135 studies (total sample size of N = 42,952), they reported small-moderate pooled effect sizes for the crosssectional and prospective relations between these constructs (rs = 0.21-0.58). Paranjothy and Wade (2024) conclude that targeting selfcriticism-potentially through evidence-based treatments augmented with compassion-focused techniques-may be necessary in those who present with highly self-critical response styles established through routine clinical assessments.…”

“…Conversely, a compassionate response style may negate these effects because it enables the person to treat themselves with kindness and understanding in moments of hardship and perceived inadequacy rather than reacting impulsively. Paranjothy and Wade (2024) conducted several meta-analyses estimating the strength of associations between self-criticism, self-compassion, and disordered eating. From 135 studies (total sample size of N = 42,952), they reported small-moderate pooled effect sizes for the crosssectional and prospective relations between these constructs (rs = 0.21-0.58).…”