The Mediating Role of Body Acceptance in Explaining the Relation of Mindfulness, Self-Compassion and Mindful Eating to Body Image in Gay Men and Bisexual Men

Mindfulness and mindfulness-based concepts, such as self-compassion and mindful eating, have been utilised in research throughout health psychology, especially in assisting populations engaging with problematic eating behaviours and experiencing body image concerns (Jordan et al., 2014; Mantzios, & Wilson, 2015; Tihanyi et al., 2016; Wasylkiw et al., 2012). Mindfulness has been described as paying attention to the present moment, with a non-judgemental attitude (Kabat-Zinn, 2015). Exploration of mindfulness has promoted the development and efficacy of mindfulness (Balciuniene et al., 2021) and compassion-based interventions (Albertson et al., 2015) aiming to attenuate body image and eating related issues in the general population, but also in more specific populations where these issues are prevalent (e.g., adolescent females; individuals with a diagnosis of Cystic Fibrosis) (Egan et al., 2021; Hussein et al., 2017). Exploration of mindfulness and related concepts have not been investigated extensively in gay and bisexual men although evidence shows that this is a population who are also at higher risk of developing eating and body image related issues (e.g., Fussner & Smith, 2015; McClain & Peebles, 2016; Tran et al., 2020). The development of interventions which consider the specific experiences of different populations increases the efficacy of such interventions, hence the need for increased knowledge of experiences of body issues in gay and bisexual men.

Within Western culture, presentation of “thin” or “slim” female body types have contributed to poor body image perception among younger female populations (Bombak et al., 2019). Those who do not meet this ideal expectation often display lower body image and dissatisfaction (Bombak et al., 2019) and perceive a lack of acceptance of their body shape from peers, family, and friends (Tylka & Homan, 2015). Body acceptance has been defined as an acknowledgement of feeling unsatisfied with some aspects of the body but accepting these non-judgementally (Tylka & Wood-Barcalow, 2015); it is often aligned with “fat acceptance” though there are many facets to body acceptance amongst different populations (Ruggiero et al., 2000). The perceived “body acceptance by others” (Swami et al., 2020) in relation to those who are close to the individual (family and friends) has also been linked to body image and mental health outcomes (Layman et al., 2021). Evidence shows that higher rates of body acceptance relate to positive body image (Swami et al., 2021). A higher prevalence for body related issues has been found in female populations including a lack of body acceptance, leading to poor body image and body dissatisfaction (Santonastaso, 1995). A large collection of research has attributed this to women internalizing the “thin” body ideals portrayed by the media (Pidgeon & Appleby, 2014). While findings generally indicate a thin “ideal body” proposition, further explorations of body acceptance and how this relates to body image and mindfulness constructs is needed.

Research that explores body image in men does not often depict the sexuality of participants and therefore does not consider the specific experiences of gay and bisexual men (Fussner & Smith, 2015). This omission is important, as recent literature has highlighted gay and bisexual men as experiencing a higher prevalence of eating and body related issues when compared with heterosexual men (Blashill, 2010). Brewster et al. (2017) suggest that the pressure upon gay men to conform to the high standards of bodily appearance in the gay community could result in disordered eating and body dissatisfaction. Yelland and Tiggemann (2003) compared measures assessing disordered eating and desire for muscularity in gay men, using heterosexual men and women as control groups. Gay men scored higher in the disordered eating and desire for muscularity measures than both the control groups (Yelland & Tiggemann, 2003). This suggests that the aspirational male gay body type is both lean and muscular. This body ideal can be difficult to achieve and maintain and may help to explain the higher rates of disordered eating. A perceived failure to achieve such body ideals may also negatively affect wellbeing in gay men (Brewster et al., 2017; Regan et al., 2021; Yelland & Tiggemann, 2003).

Qualitative explorations of body ideals in relation to social perceptions and the impact on the individual have reflected similar findings (Morgan, & Arcelus, 2009). Regan et al. (2021) highlighted the appearance-based judgement experienced by gay men who visited “gay spaces”, and how this related to a lack of body acceptance within gay men. Further findings showed that participants were judgemental of themselves when they had eaten unhealthy food, particularly when consumption was unplanned or eaten without attention (i.e., mindless eating). This research highlights the lack of body acceptance experienced and the perceived importance of attaining or maintaining a slim or muscular body type to be “accepted” within this community (Regan et al., 2021). The potential of mindfulness and self-compassion to improve body acceptance and body image is proposed (Brewster et al., 2017; Regan et al., 2021; Yelland & Tiggemann, 2003).

Literature presents several explorations of mindfulness-based interventions and their effectiveness at attenuating body related issues within the general and more specific populations. Balciuniene et al. (2021) tested an 8-week intervention programme utilising mindfulness based physical exercise and educational sessions with a sample of female college students who showed an increase in body image scores post intervention. Similarly, Zamzami et al. (2015) demonstrated that mindfulness-based exercise attenuated lower body image in female students. This provides evidence of the effectiveness of mindfulness-based interventions when addressing body related issues in specific populations (Balciuniene et al., 2021; Zamzami et al., 2015).

Self-compassion is a mindfulness-based construct which describes compassion directed towards oneself, comprising of three main elements, kindness, a sense of common humanity and mindfulness (Germer & Neff, 2013). This concept has been explored within body image and eating literature, where higher levels of self-compassion relating to higher levels of body satisfaction and lower reports of disordered or maladaptive eating (Egan et al., 2018; Mantzios & Egan, 2017; Rahimi-Ardabili et al., 2018; Regan et al., 2021). Wasylkiw et al. (2012) explored self-compassion and self-kindness in relation to body image in a sample of female university students. Higher levels of self-compassion and self-kindness were found to be predictors of higher levels of body image. Self-compassion-based interventions have also shown efficacy in reducing body dissatisfaction in female populations, Albertson et al. (2015) tested a daily audio guided self-compassion based-meditation intervention over 3 weeks, results showed higher levels of self-compassion which were associated with higher levels of body image.

Emerging research has looked at the potential influence mindful eating may have on reducing not only maladaptive eating behaviours, but also body dissatisfaction (Olvera-Ruvalcaba & Gómez-Peresmitré, 2021). Mindful eating encompasses non-judgment, eating with awareness and engaging with the physical and emotional sensations associated with eating (Mantzios, 2021). Ponde Nejadan et al. (2018) explored mindful eating, body image and quality of life in a sample of married Iranian women, showing increases of mindful eating related to increases in body image and quality of life. This research suggests that mindful eating may also play a role in promoting positive body image. Further links between mindful eating and body image are presented by Webb et al. (2018) who investigated the impact of family talk around mealtimes. Results showed that self-denigrating talk was inversely linked with mindful eating while increases in mindful eating behaviours increased positive body image and appreciation. Research proposes the importance of mindful eating (Mantzios et al., 2018), and by extension, of mindful-eating based interventions (Hussain et al., 2017; Mantzios et al., 2020a, b), when considering its potential impact on positive body image.

The links between body image and mindfulness-based concepts have been discussed (Jordan et al., 2014; Tihanyi et al., 2016; Wasylkiw et al., 2012); however, the potential link of body acceptance to mindfulness has not been extensively explored. Exploration of these concepts within gay and bisexual men would highlight elements that may be important when considering a mindful or compassion-based intervention to attenuate body and eating related issues in gay and bisexual men. The aim of this study is to explore body image and the potential relationships to mindfulness, self-compassion, and mindful eating in gay and bisexual men to inform future mindful and/or compassion-based intervention to attenuate body related issues. Importantly, the present research assumes the close association of body acceptance to body-image, and the congruent nature of acceptance to mindfulness, self-compassion, and mindful eating to be a significant indicator of promoting healthier changes towards body perceptions.