Slimming World’s unique group support system is a complex process of individual support in a powerfully motivating group setting, made simple for group members. It avoids any criticism, control or judgement and uses elements of techniques including Transactional Analysis, Motivational Interviewing, influence of ego states on behaviour and more recently Compassionate Mind Theory, to help individuals overcome their own personal barriers to change and to avoid relapse.

At Slimming World we call this positive support structure IMAGE (Individual Motivation And Group Experience) Therapy.

Based on a deep understanding of the psychology of overweight people, our support system is designed to increase the confidence and self-esteem of our members, while equipping them with tools to develop lasting self-determined behaviour change.

Our support is based on the belief that the burden carried by overweight people is two-fold. There is the burden of excess weight itself, but there is also a far heavier burden to be lifted – that of shame, self-criticism and poor self-esteem. For many overweight people, successful long-term weight loss can only be achieved by tackling these deeper emotional issues and this support is only effective when it is delivered with genuine warmth, compassion, empathy, respect and understanding.

IMAGE Therapy takes members through the phases of commitment to change: through psychological commitment and behavioural commitment and reinforces these consistently until behaviour becomes intrinsic, ie it has become important to them and they are no longer dependent on reward or praise.

Three stages of IMAGE Therapy:

Each week a member receives:

1. Appropriate praise to help them see things positively and in perspective
2. Individual attention, often with group participation, to identify problems and receive help and advice to deal positively with those problems
3. A positive conclusion with goals for the forthcoming week. Members leave group each week prepared with a plan to address potential problems, having set individual weight loss and behaviour change targets.

Beyond the group input, Consultants provide a deeper level of support as and when needed with a motivational toolkit including:

• Self-monitoring of food, feelings and emotions, including food diaries
• ‘For’ and ‘against’ evaluations
• Visualisation techniques
• Personal eating plans.

All of these address commitment to change depending on the individual member’s circumstances.

Rewarding changes and celebrating success

Goal setting and rewarding success are vital as they give each member a focus and help them to feel good about themselves. Every achievement is recognised and praised by the group, including new thinking and new decisions, even where there is no weight loss to celebrate. Members who have not lost weight get support during IMAGE Therapy by sharing experiences with people who have gone through similar situations and by receiving praise for their continued commitment.

Focus on achievement

• Members' weights are kept confidential
• Members are encouraged to set sensible and realistic goals for long-term success
• Members choose their own Personal Achievement Targets for weight loss, both short-term and long-term, when, and if, they feel ready to do so
• Members are supported in maintaining their weight loss by the offer of free life membership when personal targets are reached
• Members are initially encouraged to focus on losing and maintaining a 10% loss of body weight, highlighting the health benefits of modest amounts of weight loss

Slimming World's award system helps the member to stay motivated throughout their journey by breaking down their overall goal (one that can seem enormous at the beginning of the journey) into mini targets and rewarding gradual changes in behaviour.

Practical advice for healthier lifestyles

As well as providing members with motivation and behaviour change tools, Slimming World's IMAGE Therapy gives them the practical skills they need to bring healthier habits into their daily lifestyle.

• The weekly groups encourage members to buy everyday healthy foods and to cook from scratch for themselves and their family.
• Members share favourite recipes, best buys and special offers at local supermarkets.
• Members are encouraged to help others by talking about how they have avoided potential pitfalls, and share ideas for eating out and coping with special occasions.
• The group provides ideas and solutions to encourage activity, for allowing members to share knowledge of local facilities, discuss personal experience of new activities or even get together and become 'exercise buddies'.

Changes are gradual and results are steady, as psychological barriers to changes are broken down. With the ongoing support of the group, behavioural commitment to new healthier habits and routines is built, so that these changes become intrinsic.

Slimming World groups have the expertise and experience to help in behaviour change. They are also another brick in the wall of social support that is necessary to tackle obesity in the UK.

Andy Hill, Professor of Medical Psychology, Leeds University School of Medicine