An Imagery Rescripting Intervention for Internalized Weight Stigma in Women with Elevated Weight Concerns

Weight stigma, or negative attitudes directed toward individuals based on larger body size, is associated with decreased physical and psychological wellbeing, particularly when these attitudes are internalized and directed towards the self. The current study aimed to determine whether an online imagery rescripting intervention is effective at reducing internalized weight stigma and associated risk (fear of self-compassion and disordered eating) and protective (body image flexibility and self-compassion) factors in women with elevated weight concerns. Female undergraduate students (N = 171, 18-30 years of age) completed a screening measure and baseline assessment, and then all participants underwent a body dissatisfaction induction to re-experience their first body shame memory. Participants were then randomly assigned to either an imagery rescripting intervention group or a control group who underwent informal mindfulness. Participants in the imagery rescripting group were instructed to complete five days of imagery rescripting practice. Outcome measures were completed by all participants on day seven of the study. Contrary to hypotheses, participants in both groups displayed significant improvements on internalized weight stigma, body image flexibility, and disordered eating, whereas neither group improved on self-compassion or fear of self-compassion. Qualitative data suggest that individuals in the control group found the study to be impactful. The discussion examines the potential role of placebo and demand characteristic effects in the study results, as well as the potential impact of re-experiencing body shame combined with introspective questionnaires in producing change over the course of the study. Although the current study did not yield significant results, other recent studies have found imagery rescripting to be a promising intervention for those at risk of eating disorders. Future research should continue to explore imagery rescripting as a possible intervention for internalized weight stigma and other risk and protective factors in individuals with elevated weight concerns.