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

Objective: Future 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. 

Method: Searches 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. 

Results: Random-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). 

Discussion: Greater 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 Statement: Higher 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.