Integrating Digital Tools into Compassion-Focused Therapy for Body Image and Eating Disorder Behaviors in Adult Women

Abstract

Eating disorders (EDs) and body image disturbance remain major mental health concerns among adult women, and the persistence of shame, self-criticism, and relapse after standard treatment highlights the need for compassion-based interventions. This study investigated the effectiveness of Compassion-Focused Therapy (CFT) integrated with digital tools in improving body appreciation and self-compassion while reducing eating disorder psychopathology in adult women with disordered eating symptoms. Using a semi-experimental pretest–posttest design with a two-month follow-up, 60 women from Tehran, Iran, were randomly assigned to either an intervention group receiving 12 weekly group CFT sessions with digital support or a waitlist control group; 53 participants completed the study (26 in the intervention group and 27 in the control group). Outcomes were assessed using the Body Appreciation Scale-2 (BAS-2), the Eating Disorder Examination Questionnaire (EDE-Q), and the Self-Compassion Scale–Short Form (SCS-SF), and the data were analyzed using mixed ANOVA. The findings showed significant Time × Group interaction effects for all three outcomes, indicating superior improvement in the intervention group relative to controls. Body appreciation increased from 2.85 ± 0.71 at pretest to 3.92 ± 0.64 at posttest and remained stable at 3.88 ± 0.68 at follow-up, with a significant interaction effect, F(1.68, 85.64) = 42.35, p < 0.001, η² = 0.45. Eating disorder psychopathology declined markedly from 3.65 ± 0.89 to 2.10 ± 0.75 and was maintained at 2.15 ± 0.78, F(1.72, 87.72) = 55.18, p < 0.001, η² = 0.52. Self-compassion improved from 2.45 ± 0.62 to 3.55 ± 0.58 and remained at 3.50 ± 0.60, F(1.85, 94.35) = 38.92, p < 0.001, η² = 0.43. In contrast, the waitlist group showed no meaningful change across time. Overall, digitally supported CFT appears to be an effective and durable intervention for improving body image and reducing eating disorder symptoms in adult women.