Targeting Body Image Among Women of Higher Body Weight
Condition: Obesity; Overweight; Body Image
MeSH terms: Overweight; Body Weight
Study type: Interventional

Summary: 
      The goal of this study is to modify the evidence-based Body Project intervention to more
      powerfully target weight and shape concern among women with BMI between 25-40 using
      exploratory sequential mixed methodology (using both quantitative and focus group data).
      Initial modifications to the intervention will be made to incorporate content targeting
      weight stigma and to ensure the materials are developmentally appropriate for adult women.
      Then a small group (n=5-10) of women with high weight and shape concern will receive the 4
      week body project intervention; we will collect pre-post questionnaire data on weight and
      shape concern, thin ideal and weight stigma, and use ecological momentary assessment to
      examine in-the-moment thoughts about weight and shape. The body project intervention will
      then be revised using this information in combination with participant feedback elicited
      during a focus group session. The next iteration of the intervention will then be tested in
      another small group of n=5-10; it is estimated that it will take 4-6 iterations to achieve a
      more robust intervention program that is acceptable to the target sample. Subgroups
      (race/ethnicity, BMI class) will be evaluated to ensure suitability across groups.
    

Detailed description: 
      Women with overweight or obesity, over the age of 25, who report high weight and shape
      concern and a desire to lose weight will be recruited from the community. Participants will
      be recruited and enrolled in cohorts of 5-10 individuals, with a focus on ensuring that each
      group has approximately 50% women of color (i.e., identify as non-white).

      Participants will attend, with all individuals in their cohort, the four weekly body project
      intervention sessions led by a trained facilitator. Each session is approximately 60 minutes
      long and relies on guided discussion and group activities to engage participants. In between
      group meetings, participants will be given exercises to complete prior to the next session.
      The intervention content will be modified prior to the first cohort in order to identify
      factors relevant for body image among women who would medically benefit from weight loss
      (e.g., internalized weight bias). The active ingredients will remain the same while modifying
      content and assignments or exercises to enhance effects among the target population.

      Participants will complete a baseline assessment of self-report surveys and a 7-day
      ecological momentary assessment period. All assessment procedures must be complete prior to
      the first group meeting. After the fourth and final group meeting, participants will complete
      a second assessment including self-report surveys and a 7-day EMA period. The data collected
      from the pre and post-assessments will be used to shape the focus group script. Within four
      weeks of the last group meeting, participants will attend a focus group meeting led by a
      facilitator who was not involved in intervention delivery to better understand the
      participant experience with the intervention content. Key changes may include expanding
      content to address contextual factors that cause negative weight/shape-related thoughts among
      women with overweight or obesity and to target weight stigma (internalized), modifying
      exercises that were reviewed negatively, and incorporating explicit discussion of weight
      management.

      Following the focus group, the intervention will be revised using the quantitative and
      qualitative data collected from each cohort. The process will be repeated to refine the
      intervention through iterative testing with small groups of individuals (n≤10). It is
      anticipated that approximately 4-6 groups will be required. Upon completion of all study
      procedures, participants will receive information and resources for healthy weight loss.
    

Intervention name(s): Body Project
Intervention type(s): Behavioral
Intervention description(s): The Body project is a dissonance based intervention designed to target negative body image among adolescent females. The intervention is delivered in small groups of 5-10 individuals over 4, one-hour group sessions. This program will be iteratively revised for use among adult women with weight/shape concern and higher body weight.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment