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

Int J Eat Disord. 2024 Apr 6. doi: 10.1002/eat.24214. Online ahead of print.

Abstract

Paranjothy and Wade's (2024) meta-analysis identifying relations between self-criticism, self-compassion, and disordered eating prompted recommendations for augmenting existing front-line interventions with compassion-focused therapy (CFT) principles among self-critical individuals. While in theory this sounds promising, the reality is that the evidence supporting the use of CFT for eating disorders (EDs) is limited. I argue that before any clinical recommendations can made, more research is needed to better understand the utility of CFT, as well as what precise role self-criticism and self-compassion play in the context of intervention. In this commentary, I present three critical avenues for future research necessary to achieve this level of understanding. These include: (1) identifying moderators of response in clinical trials so that CFT can be safely delivered to those likely to benefit from this approach and avoided for those likely to experience harm; (2) establishing mediators of change so that we can understand whether CFT works through theory-specific or common mechanisms; and (3) testing the causal impact of intervention components so that knowledge on how to most effectively trigger the probable mediators of change can be gathered. This commentary will ideally spark further discussion, collaboration, and rigorous research dedicated to improving ED outcomes. PUBLIC SIGNIFICANCE: This commentary discusses the importance of further research dedicated towards enhancing understanding of the utility of compassion-focused interventions for eating disorders. It calls for more research on (1) testing moderators of response, (2) identifying mechanisms of change, and (3) establishing the most effective intervention components.

Keywords: eating disorders; mediators; moderators; randomized controlled trial; self‐compassion; self‐criticism.