ArticlePDF Available

Pilot Investigation of a Virtual Gastric Band Hypnotherapy Intervention

Authors:

Abstract and Figures

This 24-week-long pilot investigation of 30 men and women with a BMI > 27 kg/m² aimed to determine whether virtual gastric band (VGB) hypnotherapy has an effect on weight loss in overweight adults, compared to relaxation hypnotherapy and a self-directed diet. Levels of weight loss and gain ranged from −17 kg to +4.7 kg in the VGB hypnotherapy group and −9.3 kg to +7.8 kg in the relaxation group. There was no significant difference between VGB hypnotherapy as a main effect on weight loss, (X² = 0.67, p = .41, df = 1) and there was no evidence of differential weight loss over time, (X² = 4.2, p = .64, df = 6). Therefore, the authors conclude that there was no significant difference between VGB hypnotherapy and the relaxation hypnotherapy.
Content may be subject to copyright.
Full Terms & Conditions of access and use can be found at
http://www.tandfonline.com/action/journalInformation?journalCode=nhyp20
International Journal of Clinical and Experimental
Hypnosis
ISSN: 0020-7144 (Print) 1744-5183 (Online) Journal homepage: http://www.tandfonline.com/loi/nhyp20
Pilot Investigation of a Virtual Gastric Band
Hypnotherapy Intervention
Stephanie Greetham, Sarah Goodwin, Liz Wells, Claire Whitham, Huw Jones,
Alan Rigby, Thozhukat Sathyapalan, Marie Reid & Stephen Atkin
To cite this article: Stephanie Greetham, Sarah Goodwin, Liz Wells, Claire Whitham, Huw Jones,
Alan Rigby, Thozhukat Sathyapalan, Marie Reid & Stephen Atkin (2016) Pilot Investigation of a
Virtual Gastric Band Hypnotherapy Intervention, International Journal of Clinical and Experimental
Hypnosis, 64:4, 419-433, DOI: 10.1080/00207144.2016.1209037
To link to this article: https://doi.org/10.1080/00207144.2016.1209037
Published online: 02 Sep 2016.
Submit your article to this journal
Article views: 305
View Crossmark data
Intl. Journal of Clinical and Experimental Hypnosis, 64(4): 419–433, 2016
Copyright © International Journal of Clinical and Experimental Hypnosis
ISSN: 0020-7144 print / 1744-5183 online
DOI: 10.1080/00207144.2016.1209037
PILOT INVESTIGATION OF A VIRTUAL
GASTRIC BAND HYPNOTHERAPY
INTERVENTION
Stephanie Greetham, Sarah Goodwin, Liz Wells, Claire
Whitham, Huw Jones, and Alan Rigby
Hull York Medical School/HONEI, University of Hull, Hull, UK
Thozhukat Sathyapalan
Hull York Medical School/HONEI, University of Hull and Hull Royal Infirmary, Hull, UK
Marie Reid
Hull York Medical School/HONEI, University of Hull, Hull, UK
Stephen Atkin
Hull York Medical School/HONEI, University of Hull, Hull, UK
Weill Cornell Medical College Qatar, Qatar Foundation, Education City, Doha, Qatar
Abstract: This 24-week-long pilot investigation of 30 men and women
with a BMI >27 kg/m2aimed to determine whether virtual gastric
band (VGB) hypnotherapy has an effect on weight loss in overweight
adults, compared to relaxation hypnotherapy and a self-directed diet.
Levels of weight loss and gain ranged from 17 kg to +4.7 kg
in the VGB hypnotherapy group and 9.3 kg to +7.8 kg in the
relaxation group. There was no significant difference between VGB
hypnotherapy as a main effect on weight loss, (X2=0.67, p=.41,
df =1) and there was no evidence of differential weight loss over
time, (X2=4.2, p=.64, df =6). Therefore, the authors conclude that
there was no significant difference between VGB hypnotherapy and
the relaxation hypnotherapy.
Obesity prevalence has reached epidemic proportions. In England, just
over a quarter of adults (26%) were obese in 2010, and by 2030 it is esti-
mated that 41–48% of men and 35–43% of women will have a body mass
Manuscript submitted August 21, 2014; final revision accepted April 6, 2015.
Address correspondence to Stephanie Greetham, Department of Diabetes,
Endocrinology and Metabolism, Brocklehurst building, Hull Royal Infirmary, Anlaby
Road, Hull, UK. E-mail: stephgreetham@gmail.com
Color versions of one or more of the figures in the article can be found online at
www.tandfonline.com/nhyp.
419
420 STEPHANIE GREETHAM ET AL.
index of 30 kg/m2or above (Swift, Choi, Puhl, & Glazebrook, 2013).
Obesity increases morbidity and mortality, thus reducing quality of
life and productivity (Jebb, Kopelman, & Butland, 2007). Consequently,
reducing the incidence and development of obesity are major public
health concerns (Nishida, Uauy, Kumanyika, & Shetty, 2004;Jebbetal.,
2007). The National Institute for Health and Care Excellence (NICE)
clinical guidelines for obesity have recently been reviewed, and it is
estimated that the mean percentage weight loss from participating in
a lifestyle weight-management program is somewhat lower than the
originally stated 5%, with an average of around 3% of baseline weight.
The Programme Development Group have stated that even losing this
relatively small amount of weight is likely to lead to health benefits
(particularly if the weight loss is maintained for many years) (Centre
for Public Health Excellence at NICE [UK] & National Collaborating
Centre for Primary Care [UK], 2006; National Institute for Health and
Care Excellence, 2014).
Hypnotherapy is becoming more accepted as a complementary ther-
apy for certain conditions such as irritable bowel syndrome (National
Collaborating Centre for Nursing and Supportive Care [UK], 2008). In a
meta-analysis of 18 studies (six of which related to obesity), Kirsch,
Montgomery, and Sapirstein (1995) concluded that the addition of hyp-
nosis substantially enhanced treatment outcomes. They also stated that
the effect of adding hypnosis to the protocol was the most pronounced
for treatments of obesity at long-term follow-up, indicating that those
who had received hypnosis tended to continue to lose weight after the
treatment ended (Kirsch et al., 1995).
Cochrane and Friesen (1986) compared weight loss among 60 over-
weight women who were randomized into three groups: hypnosis
treatment utilizing audiotapes, hypnosis treatment without audiotapes,
and a control group. The study found that weight loss after 1 month and
again after 6 months was similar in both treatment groups but did not
occur in the control group, thus indicating that, in this study, hypnosis
was an effective treatment for weight loss (Cochrane & Friesen, 1986).
More recently, a study was conducted by Stradling, Roberts, Wilson,
and Lovelock (1998) that looked at the use of hypnotherapy as an
adjunct to dietary advice in producing weight loss. Sixty obese patients
were enrolled into either a stress-reduction hypnotherapy, energy-
intake-reduction hypnotherapy, or a dietary-advice group. Those
receiving hypnotherapy attended two sessions, a month apart, which
last 30 minutes. All participants had their weight monitored regularly
for 18 months. This study showed a statistically significant result in
favor of hypnotherapy; however, they did not utilize a control group,
and the weight loss after 18 months was clinically insignificant.
Clinical hypnosis is a procedure in which a therapist suggests that
a client experiences changes in sensation, perception, thought, and
VIRTUAL GASTRIC BAND HYPNOTHERAPY FOR WEIGHT LOSS 421
behavior with some therapists believing that hypnotic inductions pro-
duce an altered state of consciousness (Kirsch et al., 1995). Mott and
Roberts (1979) stated that, although there is evidence that hypnosis may
have a role in weight loss treatment, well-designed research studies are
needed to establish the extent of its usefulness. Stewart (2005) stated
that studies looking at hypnotherapy as a single treatment for weight
loss are limited and have shown varied levels of success.
Virtual Gastric Band hypnotherapy trains the mind and body to
accept less food by making the brain believe the stomach is smaller than
it is. It originated as a publicized but nonevidence-based intervention.
Hypnotherapists Martin and Marion Shirran are believed to be first
who pioneered the technique, and they registered the trademark for the
Gastric Mind Band in North America and Europe (Shirran, Shirran, &
Graham, 2010).
The aim of this study was to assess weight loss in overweight
individuals using VGB group hypnotherapy in comparison to group
relaxation hypnotherapy combined with a self-directed diet in another
group.
Method
Subjects
Thirty participants were recruited by advertisement in the University
of Hull common areas. Both male and female volunteers with a
body mass index of more than 27 kg/m2were included. Volunteers
who were on any previous weight-loss program, had experience with
hypnotherapy, had any coexisting medical problems, had a history of
eating disorders, had excessive use of alcohol or any recreational drugs,
were pregnant or had any recent acute illness were excluded.
Techniques
Participants were asked to attend a group hypnotherapy session
(either VGB hypnotherapy or relaxation hypnotherapy) lasting 1 hour,
every week for a 4-week period. Participants were then given a 4-week
break before they returned at Week 8 for a further 1-hour refresher
hypnotherapy session. Participants were also asked to attend at Weeks
16 and 24 to be weighed at the HONEI clinical trials unit by regis-
tered dieticians. No further hypnotherapy was provided after Week 8.
See Figure 1 for details of the trial schedule. All of the hypnotherapy
group sessions for both the VGB hypnotherapy group and the relax-
ation group were carried out by the same hypnotherapist who holds a
Practitioner Diploma in Clinical Hypnotherapy and is registered with
the General Hypnotherapy Standards Council. All sessions were held
in the seminar room at the Sports Centre of the University of Hull.
422 STEPHANIE GREETHAM ET AL.
Figu re 1. Trial schedule. Gives an outline of the number of visits each participant attended
and the therapy they received.
Virtual Gastric Band Hypnotherapy
The VGB hypnotherapy program included a number of mind-
management techniques designed to form a new set of eating habits.
The program was developed by our hypnotherapist using a mixture of
both traditional hypnotherapy (such as that described by James Braid;
Upshaw, 2006) and Ericksonian hypnotherapy (Zeig & Rennick, 1991).
VIRTUAL GASTRIC BAND HYPNOTHERAPY FOR WEIGHT LOSS 423
The VGB hypnotherapy used “imaginary surgery” to persuade partic-
ipants that the surgery has taken place (McRae et al., 2004). Before the
hypnosis began, participants were given some guidelines to follow con-
sciously, including eating three times a day, being aware of the food
consumed, being aware of the signs of becoming “full,” and aiming
to increase exercise for 30 minutes each day. In addition to attending
the VGB hypnotherapy group sessions, participants were given a self-
hypnosis recording to listen to every day to reinforce the suggestions
that were made in the group sessions. This recording included a number
of mind-management techniques designed to form a new set of eating
habits. A description of the characteristics of the virtual gastric band
hypnotherapy and the hypnotic induction procedure used to produce
the VGB can been viewed in Appendix 1.
Relaxation Hypnotherapy
The relaxation hypnotherapy consists of participants being guided
into hypnosis and given mental imagery and suggestions of relaxation,
calmness, and peace. No suggestions regarding behavior, habits, or
outcomes were used. This group also received a self-hypnosis record-
ing to listen to every day; however, this focused more on relaxation
and mental imagery and gave no suggestions regarding behavior or
habits. The relaxation group was also provided with the British Heart
Foundation’s “So You Want to Lose Weight for Good” booklet (British
Heart Foundation, 2009). This booklet is a 36-page document designed
to aid self-directed weight loss and is provided free of charge by the
registered charity the British Heart Foundation. The participants were
provided with the booklet to take away and aid their self-directed
weight loss; no active weight-loss intervention was provided. The relax-
ation hypnotherapy group regime followed an identical timeline to the
VGB hypnotherapy group. The relaxation hypnotherapy was added to
the study design so that subjects received the same amount of health
care professional input, given that it is recognized that response to
any therapy can be influenced by the amount of time spent with the
participant (Cameron, 1996). However, there was a concern that the
dropout rate would be potentially too great in the relaxation group, so
the British Health Foundation self-administered intervention was given
as an “active” intervention.
Protocol
Participants attended a screening visit at the University of Hull and,
once informed consent was gained, they were randomized to receive
either VGB hypnotherapy or relaxation hypnotherapy. Randomization
was undertaken using an online generator (GraphPad Software, 2012),
a 1:1 treatment allocation was used, and the block size was not revealed.
424 STEPHANIE GREETHAM ET AL.
The initial assessment was undertaken at the HONEI clinical trials
unit by dieticians registered with the Health Care and Professions
Council. A health questionnaire was administered, and height and
weight measurements were obtained at screening after informed con-
sent. The health questionnaire included questions asking the patient if
they had diabetes, asthma, stroke, heart attack, epilepsy, kidney prob-
lems, depression, mental illness, skin condition, or any other health
condition not listed above. Weight was taken on SECA 799 stand-
on scales and measured without shoes, and participants were asked
to wear similar clothing at each visit. Participants were told which
day to attend for their group hypnotherapy sessions, but the type of
hypnotherapy they would receive was not revealed until their first
hypnotherapy session.
Recruitment took place between January and February 2012 with the
intervention commencing in March 2012 and ending in September 2012.
Ethical permission was obtained from Hull York Medical School, the
University of Hull, where the study was undertaken. The study was
undertaken in accordance with the Declaration of Helsinki.
Statistical Analysis
Based on an expected 3 kg weight difference (SD =3.5 kg) between
the two hypnotherapy interventions, a sample size of 12 participants
was required. This calculation assumed 80% power with a two-sided
alpha error of 5%. To account for a dropout rate of 10%, we recruited
15 participants per arm. Dropout was assumed to be nondifferential
between arms.
The primary outcome measure (weight in kg) was analyzed using
mixed-effects linear regression (Verbeke & Molenbergs, 2000). We fit-
ted a full two-way factorial model of weight on treatment and time
(Fitzmaurice, Laird, & Ware, 2011). Time of measurement was measured
unevenly (baseline, 2, 3, 4, 8, 16, and 24 weeks). Probability plots were
used to check for normality of residuals. A nominal level of 5% signifi-
cance (two-tailed) was assumed. The Stata statistical computer package
was used to analyze the data (StataCorp, 2013).
Results
Descriptive Statistics
All enrolled participants met the inclusion criteria specified for
the trial (N=30). The study consisted of 28 women and 2 men.
The mean age (SD) for the VGB hypnotherapy group was 38.46
(13.97) years and 43.20 (13.71) years for the relaxation hypnotherapy
VIRTUAL GASTRIC BAND HYPNOTHERAPY FOR WEIGHT LOSS 425
group. The mean body mass index (BMI) for both groups was in the
obese range 30 kg/m2(World Health Organization, 1995)witha
mean (SD) of 34.15 kg/m2(5.87) for the VGB hypnotherapy group
and 37.30 kg/m2(6.28) for the relaxation hypnotherapy group. The
mean (SD) baseline weight for the participants was 93.56 kg (20.18) for
the VGB hypnotherapy group and 98.42 kg (18.01) for the relaxation
hypnotherapy group. There was quite a large range in the starting BMIs
of participants in both groups. The VGB hypnotherapy group ranged
from 28.03–49.94 kg/m2and the relaxation hypnotherapy group ranged
from 28.58–48.11 kg/m2, which shows a large variance in both groups.
Attendance Rate
Of the 30 participants enrolled, 25 completed the trial (VGB
hypnotherapy group n=12, relaxation hypnotherapy group n=13);
No reasons were given by the participants (n=3) that withdrew from
the VGB hypnotherapy group. In the relaxation hypnotherapy group,
1 participant withdrew due to time commitments and the other patient
failed to attend their first appointment. Twenty percent (n=3) of the
VGB hypnotherapy group did not attend the last two follow-up ses-
sions (Visits 6 and 7), which could be attributed to the fact that no
hypnotherapy was administered in the last two sessions; the partici-
pants were only weighed by the dieticians. This did not occur in the
relaxation hypnotherapy group, and all 13 participants left in the trial
by Week 24 attended at least one of the final two visits. If no weight
was recorded for the participant, the value was left blank for statistical
testing.
Comparison of Virtual Gastric Band Versus Relaxation Hypnotherapy for
Effects on Weight Loss
Absolute weights at the start of the trial ranged from 68.3–141.8 kg
for the VGB hypnotherapy group and 71.8–129.4 kg for the relaxation
hypnotherapy group. Levels of weight loss and weight gain ranged
from 17 – +4.7 kg in the VGB hypnotherapy group and 9.3– +7.8 kg
in the relaxation hypnotherapy group. Table 1 shows that there was no
significant difference between treatment as a main effect and weight
loss, (X2=0.67, p=.41, df =1), and that there was no evidence of dif-
ferential weight loss over time, (X2=4.2, p=.64, df =6). Figure 2 shows
the individual patient data of weight over time.
Discussion
In line with recommendations for pilot studies, statistical testing was
kept to a minimum (Lancaster, Dodd, & Williamson, 2004). The results
426 STEPHANIE GREETHAM ET AL.
Table 1
A Mixed-Effects Linear Regression Model: Effects Are Calculated as Differences from
the Reference Groups
Variable Effect (95% CI) pvalue
VGB 4.8 (18.5, 8.51) .41
Time (weeks) .23
20.2 (2.2, 1.3) .63
30.7 (2.4, 0.9) .39
41.4 (3.3, 0.4) .12
80.8 (2.6, 1.0) .38
16 0.8 (2.7, 0.9) .34
24 0.1 (1.8, 1.6) .88
Interaction of treatment and time .64
VGB ×2 weeks 0.6 (3.1, 1.8) .61
VGB ×3 weeks 0.8 (3.3, 1.7) .52
VGB ×4 weeks 0.2 (2.8, 2.3) .87
VGB ×8 weeks 0.5 (3.0, 2.0) .67
VGB ×16 weeks 1.0 (3.8, 1.6) .43
VGB ×24 weeks 2.4 (5, 0.1) .06
Constant 98.4 (88.7, 108.0) <.001
Random effects Estimate (95% CI)
Subject 312.4 (181.1, 538.2)
Variance (residual) 4.8 (3.7, 6.2)
of this study showed a slight trend towards a greater weight loss for
participants receiving VGB hypnotherapy in comparison to relaxation
hypnotherapy. However, these results were not statistically significant
after 24 weeks. Perhaps if the trial had run longer than 24 weeks, if the
hypnotherapy continued longer than 4 weeks, or if there had been a
larger sample size, there would have been a statistical difference in the
weight loss between the groups.
The trend towards nonattendance for Visits 6 and 7 did not occur
in the relaxation hypnotherapy group. This could be attributed to the
complementary virtual gastric band therapy treatment that was offered
to the relaxation hypnotherapy group as an incentive for completing
the trial. No incentive was offered to the VGB hypnotherapy group.
According to the power calculations completed before the start of the
trial, we required a minimum of 12 participants per group to complete
the study. This was achieved, as mentioned above.
The NICE clinical guidelines (Centre for Public Health Excellence at
NICE [UK] & National Collaborating Centre for Primary Care [UK],
2006) for obesity suggest that a weight loss of 5% of total body weight
over a 6-month period can be beneficial in terms of reducing risk of
VIRTUAL GASTRIC BAND HYPNOTHERAPY FOR WEIGHT LOSS 427
Figu re 2. Line graph of weight over time of individual patient data.
diabetes and reducing hypertension. These guidelines have recently
been under review and suggest that a weight loss as small as 3% can
lead to health benefits, especially if this weight loss is maintained long
term (NICE, 2014). Two participants in the VGB hypnotherapy group
achieved a weight loss of more than 5% compared to only 1 in the relax-
ation hypnotherapy group. Interestingly, 3 people in the VGB group and
4 people in the relaxation hypnotherapy group achieved a weight loss
of over 3%. It must be noted that the largest weight loss was achieved
by a participant in the VGB group who lost 17 kg over the 6-month trial
period, which equates to 11.9% of their body weight.
There were a number of limitations in the study design. The par-
ticipants in this study received group hypnotherapy rather than one-
on-one individualized treatment with the hypnotherapist. Wadden and
Flaxman (1981) suggest that individual sessions allow the therapist to
be maximally responsive to a patient’s treatment needs while at the
same time adhering to a standard protocol. Group treatment, however,
may possibly provide a greater social support for the dieter. During the
design of this trial, the possibility of future prescription of this proce-
dure by health care providers was considered, and it was decided that
group sessions would be the most cost-effective method. During the
group hypnotherapy sessions there was no interaction between partic-
ipants; therefore, there was limited benefit of a group setting for the
428 STEPHANIE GREETHAM ET AL.
individual. This may have prevented full participation in the session
and reduced the effectiveness of the intervention.
Another limitation is that this study did not measure hypnotizability.
In a study by Anderson (1985), it was found that the degree of
hypnotizability could influence the amount of weight lost in a hyp-
notherapeutic obesity-treatment program. They found that people who
are highly hypnotizable lost significantly more weight than the medium
or low hypnotizable participants.
In a study conducted by Bolocofsky, Spinler, and Coulthard-Morris
(1985), it was found that the use of hypnosis as an adjunct to behavioral
treatment of obesity resulted in not only a significant weight reduction
during the program but also a continued weight loss after the therapist’s
contract was terminated. These results support the use of a combined
hypnobehavioral approach, which employs hypnosis as a part of a total
treatment regimen. One main limitation to our study design is that
self-directed weight-loss information was only offered to the relaxation
hypnotherapy group and not the VGB hypnotherapy group. This was
done as an incentive to reduce the dropout rate of the relaxation group.
Ideally, this would have been offered to both groups as a combination
therapy.
Bolocofsky et al. (1985) asked participants to pay a $20 deposit that
was refunded at the completion of the program and Wadden and
Flaxman (1981) requested a $15 deposit to help with the motivation of
participants. In private practice, participants have to pay for treatment,
which may indicate that the individual is at the point where they are
actively seeking change and, when taking into consideration the expec-
tation factor, are more likely to succeed than a person receiving it free of
charge (Stanton, 1976). This may be a contributing factor as to why the
results in our study were not as conclusive as previous studies in the
field of hypnosis and weight loss.
Although it was not possible to blind participants to this interven-
tion, advertisement for this trial could have been improved. The advert
highlighted the active treatment and there was disappointment on allo-
cation to the relaxation hypnotherapy group. There is some thought that
for a highly credible control group, participants must have the same
expectation and motivation (Kazdin, 1979), and, during the design of
this trial, this was not considered.
In conclusion, there was no significant difference between the effec-
tiveness of VGB hypnotherapy and the relaxation hypnotherapy group.
This may be due to the fact that we used group hypnotherapy as
opposed to one-on-one treatment or that the treatment was given in
isolation of dietary advice rather than in combination with it. There is
definitely scope for larger trials to be conducted that address the limita-
tions we experienced during this study, but the data we collected here
do not support the theory that VGB hypnotherapy aids in weight loss.
VIRTUAL GASTRIC BAND HYPNOTHERAPY FOR WEIGHT LOSS 429
Acknowledgments
Contributors Claire Whitham and Marie Reid designed the trial.
Claire Whitham and Sarah Goodwin wrote the initial protocol. Claire
Whitham and Sarah Goodwin coordinated the study, screened and ran-
domized the participants and collected the data. Liz Wells, Alan Rigby,
and Huw Jones analyzed the data and carried out statistical tests. Liz
Wells and Stephanie Allen drafted the article with contributions from
Marie Reid, Stephen Atkin, and Thozhukat Sathyapalan. All authors
read and approved the final article. Ethical Approval was obtained from
The Hull York Medical School, University of Hull (1011) January 16,
2012.
Funding
The study was funded by the HONEI project at the University
of Hull. All authors declare no relationships or activities that would
appear to have influenced the submitted work.
References
Andersen, M. S. (1985). Hypnotizability as a factor in the hypnotic treatment of obe-
sity. International Journal of Clinical and Experimental Hypnosis,33, 150–159. doi:10.1080/
00207148508406645
Bolocofsky, D. N., Spinler, D., & Coulthard-Morris, L. (1985). Effectiveness of hypnosis as
an adjunct to behavioral weight management. Journal of Clinical Psychology,41, 35–41.
doi:10.1002/(ISSN)1097-4679
British Heart Foundation (2009), ‘So you want to lose weight for good’, London, UK.
www.bhf.org.uk
Cameron, C. (1996). Patient compliance: Recognition of factors involved and suggestions
for promoting compliance with therapeutic regimens. Journal of Advanced Nursing,24,
244–250. doi:10.1046/j.1365-2648.1996.01993.x
Centre for Public Health Excellence at NICE (UK) & National Collaborating Centre for
Primary Care (UK). (2006). Obesity: The prevention, identification, assessment and man-
agement of overweight and obese adults and children. London, UK: National Institute for
Health and Clinical Excellence.
Cochrane, G., & Friesen, J. (1986). Hypnotherapy in weight loss treatment. Journal of
Consulting and Clinical Psychology,54, 489–492. doi:10.1037/0022-006X.54.4.489
Fitzmaurice, G., Laird, N. M., & Ware, J. H. (2011). Applied longitudinal data (2nd ed.).
Oxford, UK: Oxford University Press.
GraphPad Software, 2012. GraphPad Prism 6.01. La Jolla, CA: GraphPad Software.
Jebb, S. A., Kopelman, P., & Butland, B. (2007). Executive summary: FORESIGHT
“tackling obesities: Future choices” project. Obesity Reviews,8, vi–ix. doi:10.1111/
obr.2007.8.issue-s1
Kazdin, A. E. (1979). Nonspecific treatment factors in psychotherapy outcome
research. Journal of Consulting and Clinical Psychology,47, 846–851. doi:10.1037/
0022-006X.47.5.846
430 STEPHANIE GREETHAM ET AL.
Kirsch, I., Montgomery, G., & Sapirstein, G. (1995). Hypnosis as an adjunct to
cognitive-behavioral psychotherapy: A meta-analysis. Journal of Consulting and Clinical
Psychology,63, 214–220. doi:10.1037/0022-006X.63.2.214
Lancaster, G. A., Dodd, S., & Williamson, P. R. (2004). Design and analysis of pilot stud-
ies: Recommendations for good practice. Journal of Evaluation in Clinical Practice,10,
307–312. doi:10.1111/jep.2004.10.issue-2
McRae, C., Cherin, E., Yamazaki, T. G., Diem, G., Yo, A. H., Russell, D., & Freed, C.
R. (2004). Effects of perceived treatment on quality of life and medical outcomes
in a double-blind placebo surgery trial. Archives of General Psychiatry,61, 412–420.
doi:10.1001/archpsyc.61.4.412
Mott, T., Jr., & Roberts, J. (1979). Obesity and hypnosis: A review of the litera-
ture. International Journal of Clinical and Experimental Hypnosis,22, 3–7. doi:10.1080/
00029157.1979.10403994
National Collaborating Centre for Nursing and Supportive Care (UK). (2008). Irritable
Bowel Syndrome in adults: Diagnosis and management of Irritable Bowel Syndrome in
primary care. London, UK: Royal College of Nursing.
National Institute for Health and Care Excellence (NICE). (2014). NICE Public Guidance
53 — Managing overweight and obesity in adults: Lifestyle weight management services.
London, UK: National Institute for Health and Care Excellence (NICE).
Nishida, C., Uauy, R., Kumanyika, S., & Shetty, P. (2004). The joint WHO/FAO expert
consultation on diet, nutrition and the prevention of chronic diseases: Process, product
and policy implications. Public Health Nutrition,7, 245–250. doi:10.1079/PHN2003592
Shirran, M., Shirran, M., & Graham, F. (2010). Shirrans’ solution—The gastric mind band.
Bloomington, IN: AuthorHouse.
Stanton, H. E. (1976). Fee-paying and weight loss: Evidence for an interesting interaction.
American Journal of Clinical Hypnosis,19, 47–49. doi:10.1080/00029157.1976.10403831
StataCorp. 2013. Stata Statistical Software: Release 13. College Station, TX: StataCorp LP.
Stewart, J. H. (2005). Hypnosis in contemporary medicine. Mayo Clinic Proceedings,80,
511–524. doi:10.4065/80.4.511
Stradling, J., Roberts, D., Wilson, A., & Lovelock, F. (1998). Controlled trial of
hypnotherapy for weight loss in patients with obstructive sleep apnea. International
Journal of Obesity and Related Metabolic Disorders,22, 278–281. doi:10.1038/sj.ijo.0800578
Swift, J. A., Choi, E., Puhl, R. M., & Glazebrook, C. (2013). Talking about obesity
with clients: Preferred terms and communication styles of UK pre-registration dieti-
cians, doctors, and nurses. Patient Education and Counseling,91, 186–191. doi:10.1016/
j.pec.2012.12.008
Upshaw, W. N. (2006). Hypnosis: Medicine’s dirty word. American Journal of Clinical
Hypnosis,49, 113–122. doi:10.1080/00029157.2006.10401563
Verbeke, G., & Molenbergs, G. (2000). Linear mixed models for longitudinal data.NewYork,
NY: Springer.
Wadden, T. A., & Flaxman, J. (1981). Hypnosis and weight loss: A preliminary study.
International Journal of Clinical and Experimental Hypnosis,29, 162–173. doi:10.1080/
00207148108409156
World Health Organization. (1995). Physical status: The use and interpretation of anthropom-
etry. Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva,
Switzerland: World Health Organisation.
Zeig, J. K., & Rennick, P. J. (1991). Ericksonian hypnotherapy: A communications
approachtohypnosis.InS.J.Lynn&J.W.Rhue(Eds.),Theories of hypnosis: Current
models and perspectives (pp. 275–300). New York, NY: Guilford.
VIRTUAL GASTRIC BAND HYPNOTHERAPY FOR WEIGHT LOSS 431
Pilotstudie einer virtuellen Gastric Band Hypnotherapie Intervention
Stephanie Greetham, Sarah Goodwin, Liz Wells, Claire Whitham, Huw
Jones, Alan Rigby, Thozhukat Sathyapalan, Marie Reid, und Stephen Atkin
Abstract: Diese 24-wöchige Pilotuntersuchung von 30 Männern und Frauen
mit einem BMI >27 kg/m2zielte darauf ab zu bestimmen, ob eine virtuelle
Gastric Band Hypnotherapie verglichen mit Entspannungshypnotherapie
und einer selbst angepassten Diät einen Effekt auf den Gewichtsverlust
bei übergewichtigen Erwachsenen hatte. Die Level von Gewichtsverlust
und Gewichtszunahme lagen zwischen 17 und +4,7 kg in der VGB-
Hypnotherapiegruppe und 9,3 bis +7,8 kg in der Entspannungsgruppe.
Es gab keinen signifikanten Unterschied zwischen VGB-Hypnotherapie als
Haupteffekt für den Gewichtsverlust, X2=0,67, p=0,41, df =1, und es
gab keinen Beweis für differenziellen Gewichtsverlust über einen gewissen
Zeitraum, X2=4,2, p=0,64, df =6. Daher gehen die Autoren davon aus,
daß es keinen signifikanten Unterschied zwischen VGB-Hypnotherapie und
Entspannungshypnotherapie gibt.
Stephanie Reigel
Enquête pilote sur une gastroplastie virtuelle hypnothérapeutique
Stephanie Greetham, Sarah Goodwin, Liz Wells, Claire Whitham, Huw
Jones, Alan Rigby, Thozhukat Sathyapalan, Marie Reid et Stephen Atkin
Résumé: Cette étude pilote d’une durée de vingt-quatre semaines effectuée
auprès de 30 hommes et femmes ayant un IMC >27 visait à déterminer si
l’hypnothérapie associée à un anneau gastrique virtuel (AGV) a un effet sur
la perte de poids chez des adultes obèses, comparativement à l’hypnothérapie
de relaxation et à un régime autogéré. Les pertes et gain de poids ont varié
de 17 kg à +4,7 kg au sein du groupe auquel on a administré une hyp-
nothérapie associée à un AGV, et de 9,3 kg à +7,8 kg au sein du groupe
ayant pratiqué la relaxation. On n’a relevé aucune différence significative
entre l’hypnothérapie associée à un AGV comme effet principal sur la perte
de poids, X2=0,67, p=0,41, df =1, ni de signe de perte de poids différen-
tielle au fil du temps, X2=4,2, p=0,64, df =6. Les auteurs en concluent par
conséquent qu’il n’y a aucun différence significative entre l’hypnothérapie
associée à un AGV et l’hypnothérapie à l’aide de la relaxation.
Johanne Reynault
C. Tr. (STIBC)
Investigación piloto de una intervención hipnoterapéutica de banda gástrica
virtual
Stephanie Greetham, Sarah Goodwin, LIZ Wells, Claire Whitham, Huw
Jones, Alan Rigby, Thozhukat Sathyapalan, Marie Reid, y Stephen Atkin
Resumen: Esta investigación piloto de 24 semanas con 30 hombres y mujeres
con un IMC >27kg/m2 tuvo como propósito determinar si la hipnoterapia
de banda gástrica virtual (VGB por sus siglas en Inglés) tiene algún efecto
432 STEPHANIE GREETHAM ET AL.
en la reducción de peso en adultos con sobrepeso, comparada con una hip-
noterapia de relajación y una dieta auto-dirigida. Los niveles de pérdida de
peso oscilaron entre 17kg hasta +4.7kg en el grupo de hipnoterapia VGB
y9.3kg a +7.8kg en el grupo de relajación. No se encontraron diferencias
significativas entre la hipnoterapia VGB como efecto principal en la pérdida
de peso, X2=0.67, p=.41, df =1, y no se encontró evidencia de un diferen-
cial de peso a lo largo del tiempo, X2=4.2, p=.64, df =6. Por lo tanto, los
autores concluyen que no hubo diferencias significativas entre el grupo de
hipnoterapia VGB y la hipnoterapia de relajación.
Omar Sánchez-Armáss Cappello
Autonomous University of San Luis Potosi,
Mexico
Appendix 1: Characteristics of the Virtual Gastric
Band Hypnotherapy
Session 1 (Week 1)
Imagining a gastric band operation.
Suggestions for eating smaller amounts, drinking water, stopping eating
as soon as they feel comfortable.
Metaphors for no longer using their body as a rubbish bin.
Future orientation of seeing themselves slimmer, fitter, healthier.
Reinforcement of suggestions for new eating habits.
Session 2 (Week 2)
Goal setting.
Further metaphors for listening to the instinctual signals from the stom-
ach and responding to these.
Recognizing the different parts of ourselves, that is, the part that wants
to overeat and the part that wants to be slimmer, choosing which part to
whom to listen.
Aversion therapy for specific food types if they have an issue, that is,
chocolate (using an imaginary fat bucket, what the fat looks and smells
like).
Future Projection, seeing themselves slimmer.
Further suggestion therapy, smaller amounts, etc.
Session 3 (Week 3)
Further consideration of possible future outcomes.
The cinema technique and making choices seeing themselves on a screen,
slimmer and healthier, imagining jumping into the screen, and feeling all
the feelings that they will have when they reach their goal (associating
feelings of confidence, health, etc.).
VIRTUAL GASTRIC BAND HYPNOTHERAPY FOR WEIGHT LOSS 433
Releasing things that have held them back in the past, that is, comfort
eating.
Further suggestion therapy for smaller amounts.
Session 4 (Week 4)
Reinforcement of all the above sessions.
Session 5 (Week 8)
Refresher session.
Article
Full-text available
Im Auftrag der Milton Erickson Gesellschaft für Klinische Hypnose erfolgt jährlich eine Literatursuche zu randomisierten kontrollierten Studien (randomized controlled trials; RCTs) und Meta-Analysen, die sich mit der Wirksamkeit von klinischer Hypnose und Hypnotherapie befassen. Im Jahr 2016 wurden zwölf randomisierte bzw. quasi-randomisierte Studien mit klinischen Stichproben gefunden, die den Einsatz von Hypnose mit einer Kontrollgruppe verglichen, und zwei weitere, die hypnotherapeutische und kognitiv-behaviorale Elemente kombiniert evaluierten. Zusammen mit den Ergebnissen aus den 2016 publizierten Meta-Analysen mehren sich die Belege für einen möglichen Zusatznutzen von Hypnose in der Behandlung von somatischen Syndromen, in dem Sinne, dass sich auch die psychische Begleitsymptomatik verbessert. Gerade für gestörten Schlaf als sekundäre Ergebnisvariable könnte es lohnen, dies me ta-analytisch, z.B. in onkologischen oder gynäkologischen Studien zu überprüfen. Ein Blick auf die derzeit laufenden oder jüngst abgeschlossenen RCTs lässt außerdem auf weitere Ergebnisse zur Wirksamkeit der Hypnose bei Schlafproblemen hoffen.
Article
Full-text available
Objective: To describe trainee healthcare professionals' preferred terms when talking about obesity, their beliefs about initiating discussions about weight, and their confidence about consulting with obese people. Methods: A self-completed questionnaire collected data on demographics, preferred terms, beliefs about initiation of discussions, confidence and training needs from 1036 pre-registration dieticians, nurses and doctors. Results: Participants' preferred terms when raising the issue of obesity with clients were BMI (mean=.96), weight (mean=.71) and unhealthy BMI (mean=.43). When defining a client's bodyweight, students endorsed the euphemism 'your weight may be damaging your health' (67.6%). A proactive, collaborative communication style was preferred by 34.9% of participants. 58.2% of participants felt confident about discussing obesity with clients and 95.1% felt that that more training would be useful. Conclusion: It is reassuring that U.K. trainee healthcare professionals avoid value-laden terms and broadly endorse words preferred by people with obesity. It is, however, concerning that the majority of participants did not favor a proactive, collaborative communication style. Practice implications: Educators of tomorrow's healthcare professionals could take advantage of students' desire for more training on how to effectively talk to clients with obesity about their weight. Such training would, however, require the development of clear guidelines on terminology and communication styles.
Article
Hypnosis has been reported as a treatment for obesity for many years but there have been no reviews of this literature. In this review all of the journal articles found are summarized briefly but because of lack of comparable information no attempt is made to critically compare the methods used. Most of the reports are anecdotal and very few report detailed results or follow-up. It is concluded that although there is evidence that hypnosis may have a role in the treatment of obesity, well-designed research studies are needed to establish the extent of its usefulness and the most effective methods of using hypnosis in the treatment of the different types of obesity.
Article
[present] an initial brief examination of the historical context and theoretical environment—against which Milton Erickson's hypnosis and hypnotherapy can be seen / examine some of the differences in the way psychotherapy and hypnosis have evolved; consider the major efforts to define hypnosis; and then offer an alternative view of hypnosis based on an interactional perspective theoretical concepts and principles / the means: promoting interpersonal influence / different perspectives on Ericksonian practice (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Chapter
The analysis of longitudinal data may require a mixed-effects model, incorporating parameters for fixed effects associated with the whole population and also parameters describing distributions of random effects associated with individual subjects. These may enter the model nonlinearly, as in compartment models used in pharmacokinetics. Maximum likelihood estimation is carried out by numerical optimization. Keywords: repeated measures; growth curves; pharmacokinetics; compartment models; random effects
Article
To assess if hypnotherapy assists attempts at weight loss. Randomised, controlled, parallel study of two forms of hypnotherapy (directed at stress reduction or energy intake reduction), vs dietary advice alone in 60 obese patients with obstructive sleep apnoea on nasal continuous positive airway pressure treatment. National Health Service hospital in the UK. Weight lost at 1, 3, 6, 9, 12, 15 and 18 months after dietary advice and hypnotherapy, as a percentage of original body weight. All three groups lost 2-3% of their body weight at three months. At 18 months only the hypnotherapy group (with stress reduction) still showed a significant (P < 0.02), but small (3.8 kg), mean weight loss compared to baseline. Analysed over the whole time period the hypnotherapy group with stress reduction achieved significantly more weight loss than the other two treatment arms (P < 0.003), which were not significantly different from each other. This controlled trial on the use of hypnotherapy, as an adjunct to dietary advice in producing weight loss, has produced a statistically significant result in favour of hypnotherapy. However, the benefits were small and clinically insignificant. More intensive hypnotherapy might of course have been more successful, and perhaps the results of the trial are sufficiently encouraging to pursue this approach further.
Article
Discusses salient issues raised by W. Wilkins . The term nonspecific treatment factors usually refers to several, often unspecified, variables that may influence therapy outcome. The word nonspecific denotes that these factors may extend to many different techniques. Recent research has demonstrated that treatment and control conditions differing from each other in overall efficacy may also differ in such factors as their credibility to the client and in the expectancies for improvement they generate. Relatively high levels of credibility and expectancies for improvement may be inherent in most, if not all, treatments. The task for therapy research is not to demonstrate that treatment operates free from such factors. Rather, the task is to demonstrate that specific treatment techniques considered to carry the burden of client change go beyond the results that can be obtained by implementing procedures that produce change merely because of their relatively high levels of credibility and treatment-generated expectancies. The present article briefly examines the conceptual and methodological issues raised by nonspecific treatment factors and the interpretive problems these factors pose for selected outcome questions. (27 ref)
Article
Patients wishing assistance in losing weight were allocated to one of two treatment conditions on the basis of time of application. Under one condition, they paid the usual fee for the therapy they received; under the other, no such payment was required. Over a period of eight weeks, patients received four treatment sessions during which they were hypnotized and given suggestions relating to weight loss. Measures of weight were taken before the first session and two weeks after the fourth and final session. This data indicated that fee-paying patients recorded significantly greater weight loss than non-fee paying patients, a finding that was explained in terms of expectancy.
Article
The reliability and validity of a self-report measure of combat exposure are examined in a cohort of male-male twin pairs who served in the military during the Vietnam era. Test-retest reliability for a five-level ordinal index of combat exposure is assessed by use of 192 duplicate sets of responses. The chance-corrected proportion in agreement (as measured by the kappa coefficient) is .84. As a measure of criterion-related validity, the combat index is correlated with the award of combat-related military medals ascertained from the military records. The probability of receiving a Purple Heart, Bronze Star, Commendation Medal and Combat Infantry Badge is associated strongly with the combat exposure index. These results show that this simple index is a reliable and valid measure of combat exposure.