Although obesity is known to pose significant health risks, the prevalence has recently increased rapidly, with almost one fifth of women obese in 1996. Although research suggests that most people understand the behaviour changes necessary for weight control, few people appear to be engaging in the required behaviour to improve their health. With reference to the literature this thesis considered how an understanding of psychological factors can contribute to understanding and treating the condition. The research was found to be at a relatively early stage in terms of understanding the experience of obesity. In such situations qualitative research methods can explore experience in detail, providing information about phenomena such as thought processes and emotions, and may be of heuristic value. To address these issues a community sample of obese women (n 7) were interviewed about their weight and related issues. Participants' accounts were subjected to an Interpretative Phenomenological Analysis to elucidate their views of their situation through an interpretative process. They presented their understanding of how they had come to be and remain in their situation (a collection of themes entitled Explanatory Models'). Although participants expressed the view that weight is under individuals' control, they indicated that weight-control was not currently possible or desirable for themselves (Beliefs about the Controllability of Weight'). Being big had negative personal meanings and was associated with Abstract & Declarations 1.2 emotional distress ('Persona! Meaning of Being Big'). Interestingly participants described processes that appeared to mediate between being big and the personal impact of this, including not thinking of themselves as big, viewing size as unimportant in their lives, and making favourable comparisons between themselves and others or previous selves (Mediating Processes'). These findings were discussed with reference to the literature and their implications for future clinical and research approaches. Issues related to the research process were also discussed.

The following research thesis discusses issues relevant to shame and psychological distress in women who are overweight or obese. The literature review summarises current knowledge regarding the relationship between binge eating and depression in obesity. Although largely based upon literature from the field of psychiatry, the review is intended to provide an overview for clinical psychologists. The literature is critically evaluated in terms of methodologies and theoretical approaches, and ideas for further research are suggested. In the final section, the clinical implications of the literature for clinical psychologists working with clients who are overweight and who binge eat are discussed. The brief paper explores the factor structure of an extended version of the "Experience of Shame Scale" (E. S. S. ) and the reliability of the extended scale in a community sample of women. Principal components analysis revealed that a three-factor solution was appropriate for this sample, demonstrating that the salient factors of shame in women are: - characterological shame, behavioural shame and bodily shame. To the author's knowledge, this is the first study to measure shame in a community sample of women. The main paper investigates shame and psychological distress in a community sample of women who are overweight or obese. The study compares four groups of women, categorized according to Body Mass Index. The results demonstrated that women who were severely obese experienced significantly higher levels of shame and psychological distress than all other groups. They received significantly higher scores on all four subscales of the E. S. S (characterological, behavioural, bodily and eating shame) and also had significantly lower self esteem. The reflective review discusses issues arising from the research which may be of benefit to other applied and professional psychologists. It is divided into five sections - personal reflections on the research process, ethical considerations, methodological issues, empowerment in research and the use of psychiatric terminology in this study.

This Health Services Research PhD, funded by the Chief Scientist Office (CSO), investigated the psychosocial aspects of obesity in a community sample of men and women aged 30-60 living in deprived and affluent areas of Greater Glasgow. The study incorporated a mixed method design and combined a community health survey and semi-structured interviews with a purposively selected sub-sample of questionnaire respondents. 52% of the participants who completed the questionnaire were either overweight or obese and 16% were defined as obese. Obesity and body image were not significant predictors of poor psychological health. Furthermore, low self-esteem was the most significant predictor of poor psychological health for both men and women. The quantitative and qualitative findings demonstrate that obese individuals are aware of their current weight status and express a desire to lose weight. Potential motivating factors for weight loss included health concerns, appearance, special occasions and psychological factors such as increased self-esteem and self-confidence. Participants were knowledgeable about the causes of obesity and had absorbed and understood health promotion messages regarding healthy eating and physical activity. However, they identified a number of barriers, which prevented them from fully implementing health promotion advice. The qualitative findings suggest the possibility of a cyclical relationship between dieting depression and emotional eating. In addition, the findings demonstrate that weight cycling – losing and regaining weight – was a common experience for the interviewees. As weight cycling is a potentially damaging health problem, it might be more appropriate to encourage obese individuals to maintain a stable weight and improve their health by re-focusing the issue on fitness rather than fatness.