Article

Effects of Self-Conditioning Techniques (Self-Hypnosis) in Promoting Weight Loss in Patients with Severe Obesity: A Randomized Controlled Trial: Self-Hypnosis in Obesity

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Abstract

Objective The usefulness of the rapid‐induction techniques of hypnosis as an adjunctive weight‐loss treatment has not been defined. This randomized controlled trial evaluated whether self‐conditioning techniques (self‐hypnosis) added to lifestyle interventions contributed to weight loss (primary outcome), changes in metabolic and inflammatory variables, and quality of life (QoL) improvement (secondary outcomes) in severe obesity. Methods Individuals (with BMI = 35‐50 kg/m²) without organic or psychiatric comorbidity were randomly assigned to the intervention (n = 60) or control arm (n = 60). All received exercise and behavioral recommendations and individualized diets. The intervention consisted of three hypnosis sessions, during which self‐hypnosis was taught to increase self‐control before eating. Diet, exercise, satiety, QoL, anthropometric measurements, and blood variables were collected and measured at enrollment and at 1 year (trial end). Results A similar weight loss was observed in the intervention (−6.5 kg) and control (−5.6 kg) arms (β = −0.45; 95% CI: −3.78 to 2.88; P = 0.79). However, habitual hypnosis users lost more weight (−9.6 kg; β = −10.2; 95% CI: −14.2 to −6.18; P < 0.001) and greatly reduced their caloric intake (−682.5 kcal; β = −643.6; 95% CI: −1064.0 to −223.2; P = 0.005) in linear regression models. At trial end, the intervention arm showed lower C‐reactive protein values (β = −2.55; 95% CI: −3.80 to −1.31; P < 0.001), higher satiety (β = 19.2; 95% CI: 7.71‐30.6; P = 0.001), and better QoL (β = 0.09; 95% CI: 0.02‐0.16; P = 0.01). Conclusions Self‐hypnosis was not associated with differences in weight change but was associated with improved satiety, QoL, and inflammation. Indeed, habitual hypnosis users showed a greater weight loss.

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... Hierin lag eine weitere Limitation dieser Studie, die zeigt, wie schwierig es ist, ein hinsicht lich des Vergleichs optimales Design zu entwickeln: Damit in der Kon troll bedingung nicht unabsichtlich "hypnotische Kommunikation" zum Einsatz kommen würde, wurden unterschiedliche Operationsteams pro Arm eingesetzt und die Teams der Kontrollbedingung hatten an keinen entsprechenden Fortbildungen teilgenommen. Amraoui et al. vermuten, dass (Jong, Boers, van Wietmarschen et al., 2018) und zwei weitere primär mit Verhaltensänderungen, nämlich mit der Steigerung von Komplianz bei der Behandlung von Tuberkulose (Prasetya, Murti, Anantanyu et al., 2018) und mit der Reduktion von Gewicht (Bo, Rahimi, Goitre et al., 2018). Zwei Studien behandeln typische psychische Beschwerden, nämlich Angst vor und wäh -rend Konzerten bei Musiker/innen (Brooker, 2018) und Angststörungen bzw. ...
... Auch bei Bo et al. (2018) zur Reduktion von Übergewicht war der Anteil an zusätzlicher Aufmerksamkeit in der experimentellen Bedingung größer. Das Stan dardvor gehen in der Kontrollgruppe bestand in individualisierter Diät-und Lebensstil be ratung, während die Teilnehmenden in der experimentellen Bedingung zusätzlich ein rund 30-minütiges Training zur Selbsthypnose erhielten mit zwei weiteren Terminen zur Auffrischung. ...
... So erklären sich auch die Ergebnisse in der Studie von Jong et al. (2018) zur Behandlung von primärem Kopfschmerz bei Kindern und Jugendlichen (jeweils zwischen 42 und 45 Kinder in drei aktiven Studienarmen). Bei Bo et al. (2018) zur Reduktion von Übergewicht und bei Rizzo et al. (2018) zum Umgang mit chronischen Rückenschmerzen kamen als Kontrollgruppen Patientenschulungen zum Einsatz, die in den experimentellen Bedingun gen durch zusätzliche Hypnose ergänzt wurden. Damit favorisierte das Design eigentlich ohnehin die jeweilige Hypnosebedingung, weil die dort Teilnehmenden schon rein zeitlich mehr Intervention erhielten. ...
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Im Auftrag der Milton Erickson Gesellschaft für Klinische Hypnose e. V. 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 2018 wurden zwölf neu publizierte randomisierte Studien mit klinischen Stichproben gefunden, die den Einsatz von Hypnose mit einer Kontrollgruppe verglichen haben. In drei weiteren RCTs wurde jeweils in allen Studienarmen Hypnose eingesetzt, und in fünf RCTs wurde eine Kombination von Hypnose mit anderen therapeutischen Ansätzen evaluiert. Hinsichtlich der Indikationen überwiegt weiterhin der Einsatz von Hypnose als Adjunkt bei medizinischen Eingriffen und zum Umgang mit chronischen Schmerzen oder anderen körperlichen Beschwerden. Wie schon in den Vorjahren lässt sich ein Zuwachs an Forschung zur klinischen Anwendung der Hypnose beobachten, auch bei den neu angemeldeten RCTs. Allerdings sind knapp ein Drittel der 2018 publizierten RCTs nicht detailliert genug berichtet, was ihre Methodik, aber auch Limitationen im Studiendesign angeht. Solche Mängel in der Berichterstattung finden sich häufiger in älteren Studien, die vor der Einführung entsprechender Berichtsstandards erstellt wurden, was wiederum die Aussagekraft der neu publizierten Meta-Analysen einschränkt. Insgesamt sind damit 2018 nur wenige belastbare Ergebnisse zur Evidenzlage der klinischen Hypnose neu hinzugekommen. An annual literature search that is funded by the Milton Erickson Society of Clinical Hypnosis in Germany, revealed altogether twelve randomized controlled trials (RCTs) that evaluated clinical hypnosis in comparison to a control group and were newly published in 2018, as well as several meta-analyses that included primary studies with hypnosis as intervention. In three other RCTs, hypnosis was used in all study arms, and five RCTs evaluated interventions that combined hypnotherapeutic and other therapeutic approaches. In terms of clinical indications, hypnosis was most often used as adjunct to standard care to alleviate pain or distress related to medical procedures, or for managing chronic pain or other somatic symptoms. As in previous years, the number of studies evaluating clinical hypnosis is growing, as is the number of newly registered trials. However, almost one third of the RCTs published in 2018 are not reported in sufficient detail with regard to research methods and limitations. And since such shortcomings in reporting are more common in older studies that were published before the introduction of current reporting standards, they also limit the validity of results in the meta-analyses published in 2018. All in all, only a few reliable results could be added to the evidence base of clinical hypnosis.
... The flow diagram of study selection is shown in Fig. 1. The articles were published between 1985 and 2018 and included three randomized controlled trials [19][20][21], one three-arm quasi-experimental study [22] and three quasi-experimental studies with a pre-post-test control group design [23][24][25]. ...
... Most studies were conducted in Europe [19][20][21], two in the United States of America [22,25], and the remaining studies were conducted in Canada [24] and Indonesia [23]. Participant recruitment was conducted via newspaper advertisements for three studies [20,24,25], from clinics in two studies [22,23] and from hospitals in another two studies [19,21]. ...
... Most studies were conducted in Europe [19][20][21], two in the United States of America [22,25], and the remaining studies were conducted in Canada [24] and Indonesia [23]. Participant recruitment was conducted via newspaper advertisements for three studies [20,24,25], from clinics in two studies [22,23] and from hospitals in another two studies [19,21]. ...
Article
Obesity and overweight problems are serious global health issues today and despite many efforts, the prevalence has continued to rise for decades. Interestingly, hypnotherapy has been gaining recognition as an effective treatment for obesity and overweight problems. This review compiles contemporary scientific research on the effectiveness of hypnotherapy for weight reduction. Scopus, PubMed and EBSCO Host databases were applied in the study. The search identified 119 articles, of which seven met the inclusion criteria. A total of 539 respondents (82.7% women and 17.3% men) between the ages of 17 and 67 years were represented in the seven studies. Most studies incorporated lifestyle changes, such as changes of dietary habit and behavioral recommendations in the hypnotic procedure. Their results suggested that the use of hypnotherapy not only promoted weight reduction during the treatment period but also after treatment cessation, and in some cases, one to ten kilograms were lost during follow-up periods. In addition, one study even showed increased physical activity among the hypnotised individuals. This use of hypnotherapy also improved respondents’ eating behavior and quality of life. However, a definitive conclusion could not be drawn due to several methodological flaws and the limited number of published studies in this area. Therefore, further well-designed studies are needed to substantiate the effectiveness of hypnotherapy for this modern-day health problem.
... In most studies, the participants were asked to follow a low-calorie diet and exercise regularly. 11,13,15,18,19 Five studies entailed a non-dieting approach in which participants required to maintain their dietary habits 14,16,17,20,21 and one study instructed participants to perform exercise moderately without dietary restrictions. 12 Eight review articles were identified from 2015 to 2019 which described the effectiveness of CATs related to acupoint embedment and dietary supplements on weight loss in obese and overweight participants. ...
... According to one RCT study on 120 participants with BMI ranges from 35 to 50 kg/m 2 , the addition of hypnotherapy to conventional lifestyle modification leads to a relatively small reduction in body weight. 18 However, those practicing self-hypnosis more than once per day showing greater weight loss and improved dietary intake after follow-up for 12 months (P < 0.001). At present, it is still unclear whether hypnotherapy is effective for reducing body weight because of limited research available. ...
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Despite various strategies, overweight and obesity problems are still increasingly prevalent worldwide with serious health outcomes. Consequently, the continuous demand for more effective, safe and acceptable therapies for reducing body weight is also escalating—including complementary and alternative therapies (CATs). The aim of this review is to provide a summary of the most commonly- and recently-used CATs, with evaluation of their safety and efficacy for weight loss. Electronic scientific databases such as Scopus, PubMed and EBSCO Host were explored for articles that reported CATs for overweight and obesity treatment from 2015 to December 2019. Only systematic reviews, meta-analysis and randomized controlled trials (RCTs) published in English were included. Studies whereby CATs were not utilized for reducing body weight were excluded. Eight systematic reviews and meta-analyses and 11 additional RCTs with 765 participants (50.2% overweight and 49.8% obese) related to hypnotherapy, acupuncture and dietary supplements met the inclusion criteria. Their results suggested that spirulina, chitosan, probiotic, EPA + DHA, vitamin D, fiber, and herbal extract supplementation may all provide small reductions in body weight (ranging from 1-10 kg). Interestingly, hypnotherapy and acupuncture reported significantly greater reduction in body weight compared with placebo (p < 0.001 and p < 0.0001, respectively). Nonetheless, the evidence is still relatively limited and not encouraging to provide a definitive conclusion due to the methodological shortcomings and the presence of adverse events in chitosan and fiber supplementation. Hence, studies of this nature need to be further replicated and improved to corroborate the efficacy and safety of the CATs to combat weight issues.
... In the selfhypnosis arm, a significant improvement in quality of life, satiety, and inflammation occurred with respect to controls with standard care, without a significant difference in weight loss (−6.5-kg intervention group, n=44 patients; −5.6-kg control group, n=42 patients; p=0.79). Indeed, within the intervention group, habitual hypnosis users showed a greater weight loss than those who practiced self-hypnosis less frequently (−9.6 kg, ≥ once per day; −7.5 kg <once per day; +0.2 rarely or none; p=0.001) [48]. The same research group reported an acute effect on the brain peptides involved in the hunger/satiety regulation after a hypnosis-induced hallucinated meal in highly hypnotizable individuals, thus suggesting the potential role of hypnosis on central appetite modulation [49•]. ...
... Furthermore, the methodological quality was limited; most studies had an observational design, a low number of enrolled patients, short duration of the intervention, and only a few reported follow-up data. Patient recruitment might be a challenge in hypnosis-based interventions, the individual hypnotizability is still a highly debated question [41], and the available papers reported an increased female participation, with high rates of drop-out or discontinuation of the intervention [43,44,48]. Due to the small sample sizes, some studies might lack the statistical power to detect differences between the interventions [54], and divergent effect size values were reported in meta-analyses [38-40, 44, 46]. ...
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Purpose of Review The aim of this narrative review was to summarize the evidence evaluating the possibilities and limitations of self-hypnosis and mindfulness strategies in the treatment of obesity. Recent Findings Psychological factors, such as mood disorders and stress, can affect eating behaviors and deeply influence weight gain. Psychological approaches to weight management could increase the motivation and self-control of the patients with obesity, limiting their impulsiveness and inappropriate use of food. The cognitive-behavioral therapy (CBT) represents the cornerstone of obesity treatment, but complementary and self-directed psychological interventions, such as hypnosis and mindfulness, could represent additional strategies to increase the effectiveness of weight loss programs, by improving dysfunctional eating behaviors, self-motivation, and stimulus control. Summary Both hypnosis and mindfulness provide a promising therapeutic option by improving weight loss, food awareness, self-acceptance of body image, and limiting food cravings and emotional eating. Greater effectiveness occurs when hypnosis and mindfulness are associated with other psychological therapies in addition to diet and physical activity. Additional research is needed to determine whether these strategies are effective in the long term and whether they can be routinely introduced into the clinical practice.
... 32 It's a noninvasive intervention and free of side effects, helping to improve patients' quality of life. 33 The current study intended to examine the impact of hypnosis and hypnotherapy in the management of symptoms of people with MS, such as stress, chronic pain, an inferior quality of life, and a lack of psychological well-being. ...
Context: Stress and chronic pain are the factors that most influence the quality of life and well-being of people with MS, and 90% of adults with MS suffer from persistent fatigue. These symptoms can be associated with other disorders such as depression, and drug treatments provide inadequate comfort for most people with them. Objective: The study intended to examine the impact of hypnosis and hypnotherapy in the management of symptoms of people with multiple sclerosis (MS), such as stress, chronic pain, an inferior quality of life, and a lack of psychological well-being. Design: The research team performed a systematic narrative review by searching the PubMed and Web of Science databases, including review articles and other studies for additional citations. Setting: The study was conducted at our Scientific Institute for Research (IRCCS) in Messina. Results: Only 14 of 121 publications met the inclusion criteria and were selected. Hypnotic treatment is an effective therapy that has beneficial impacts on the intensity of perceived pain, psychological well-being, mood disorders, and fatigue, and in addition, it significantly improves physical functioning in MS patients. The same effects haven't been obtained with other nonpharmacological techniques. Conclusion: Hypnosis is an appropriate psychological therapy for the management of MS patients' symptoms.
... Counsellors work with those suffering grief and loss, pain, eating disorders, anxiety, depression, illness, stress, acceptance, and relationship issues. There has been considerable research conducted regarding a variety of conditions and issues treated by counsellors that are also being treated by hypnotherapists, including chronic pain (Ahmadi et al., 2018;Taylor & Genkov, 2020), depression (Shih et al., 2009Yapko, 2006 (Lancaster & Stead, 2017), weight loss (Bo et al., 2018), eating disorders (Milling et al., 2018), and irritable bowel syndrome (IBS) (Paulton et al., 2021)). ...
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Counselling and Hypnotherapy: Together for (almost) the first time The purpose of this article is to explore how hypnotherapy can be utilised in counselling practice. The literature discusses the advantages of using hypnotherapy techniques for multiple issues often treated in counselling. This literature review will provide counsellors and other therapists with information on the various ways hypnotherapy can aid client issues when integrated into counselling and psychotherapy practices. The aim is to have counsellors and psychotherapists better informed on the uses of hypnotherapy and consider if learning and using hypnotherapy within their practice may further aid their therapy work. The article explores how the counselling therapist could consider integrating hypnotherapy within their therapy practice. Hypnotherapy boasts swiftness of change in the manner a person thinks, feels, and behaves. This paper will provide insight for counsellors and psychotherapists in relation to the use of hypnotherapy as a possible addition to their practice.
... Hypnosis has been suggested as a potential tool for the management of obesity because it could help in controlling the compulsive and uncontrolled behaviors leading people to eat in less conscious ways [10,11]. Although many individuals approach hypnosis with skepticism and even if the effects of hypnosis on weight loss are controversial [12,13], it has been successfully used to modulate gastrointestinal motility and sensory functions [14][15][16][17]. Food imagery stimulated by hypnosis, especially of an appetizing meal, promotes gastric secretion and changes in motility, inducing variation in subjective appetite that are similar to those determined by a real meal [15,18]. ...
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The use of hypnosis can generate hallucinatory phenomena, which ranged from vivid/auditory imagery to fully developed “hallucinations” in selected people. The aim of this pilot trial was investigating the acute effects of a hypnosis-induced hallucinated breakfast (HB) compared to those of a real breakfast (RB) on subjective appetite and appetite-regulating hormones in highly hypnotizable individuals. Eight healthy post-menopausal women were recruited to consume two meals: the HB and the RB in a randomized crossover design. Participants underwent appetite sensations measurements (before meal and each 30-min until 270-min) and blood sample collection (at 0, 20, 60, 90, 180-min). A 3-day food-record was filled after each meal. The adjusted repeated measures ANCOVA did not show any meal×time interactions on subjective appetite postprandially. As expected, significantly higher glucose (p < 0.001), insulin (p < 0.001), and lower free fatty acid (p < 0.001) concentrations were found after the RB, but not following HB. Furthermore, RB significantly increased postprandial levels of glucagon-like-peptide-1 and peptide-YY at 20, 60, 90 and 180-min, whereas acylated-ghrelin and leptin levels did not differ. Postprandial neuropeptide-Y and orexin-A values significantly increased at different time-points after RB, but not following HB, while α-melanocyte-stimulating hormone levels enhanced after HB only. Energy intakes were significantly lower after HB on the test-day only (HB = 1146.6 ± 343.8 vs RB = 1634.7 ± 274.2 kcal/d; p = 0.003). Appetite sensation might be modulated by fully developed meal “hallucination” induced by hypnosis, likely affecting brain-peptides implicated in the appetite regulation. However, further studies are needed to verify these results obtained in a highly selected group of individuals. NCT03934580.
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Hypnosis has been increasingly used in recent years as an alternative treatment to maintain well-being. Yet, limited evidence is available regarding its role in weight management, especially in Malaysia. Hence, this quasi-experimental study was conducted to evaluate the effectiveness of hypnosis on weight loss and body composition (body mass index, waist circumference and body fat percentage) among staff and students of a public university in Terengganu, Malaysia. Participants with body mass index (BMI) ≥ 25.0 kg/m2 were randomly assigned to either intervention group (IG = 53) or control group (CG = 54), for 12 weeks. All participants received health education (diet + exercise + behavioral recommendations) with those in IG had additional three hypnotherapy sessions, once a month. Body weight was measured at week 1, 7, and 12 while body compositions were measured at weeks 1 and 12. Descriptive, univariate, and repeated-measures analysis of covariance (ANCOVA) were utilized. A total of 104 participants completed the trial (mean age = 26.28 ± 8.01; female = 82.2%; BMI = 31.39 ± 4.89). A significant weight loss was observed in the intervention (-4.61%) and control (-3.04%) groups (mean difference = -1.57; 95%CI: -2.59, -0.54; p = .003) after 12 weeks. Participants that frequently practiced self-hypnosis lost more weight (-6.27%; t(50) = -5.331, p < .001). Body fat percentage and waist circumference did not significantly change from baseline in both groups. Essentially, the positive outcomes indicated the promising potential of hypnosis as an alternative tool in facilitating weight loss efforts for those in need.
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Abstract Hypnosis has long been recognized as an effective tool for producing behavioral change in the eating disorders anorexia and bulimia. Despite many studies from the latter half of the last century suggesting that hypnosis might also be of value in managing obesity situations, the efficacy of hypnotherapy for weight reduction has received surprisingly little formal research attention since 2000. This review presents a brief history of early clinical studies using hypnosis for weight reduction and describes a hypnotherapeutic approach within which a combination of instructional/pedagogic and exploratory therapeutic sessions can work together synergistically to maximize the potential for sustained weight loss. Hypnotic modulation of appetite- and satiation-associated peptides and hormone levels may yield additional physiological benefits in Type 1 and Type 2 diabetes.
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In this paper we review the possibilities and limitations of hypnotherapeutic techniques in the treatment of obesity. In spite of some promising reports, the findings and opinions about the effectiveness of hypnosis in the treatment of obesity vary greatly. We provide a brief overview of specific hypnotherapeutic techniques--such as teaching relaxation, increasing self-control, encouraging physical exercise, altering self-esteem and body image, strengthening motivation, and exploring ambivalence for change--that can be involved in a multidimensional approach to obesity. Case reports illustrate the use of these techniques.
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To investigate the influence of weight loss expectations (expected 1-year BMI loss, dream and maximum acceptable BMI) on attrition in obese patients seeking treatment. Obese subjects (1,785; 1,393 women; median age, 46 years; median BMI, 36.7 kg/m(2)) seeking treatment in 23 medical Italian centers were evaluated. Baseline diet and weight history, weight loss expectations, and primary motivation for seeking treatment (health or improving appearance) were systematically recorded. Psychiatric distress, binge eating, and body image dissatisfaction were tested at baseline by self-administered questionnaires (Symptom Check List-90, Binge Eating Scale, and Body Uneasiness Test). Attrition and BMI change at 12 months were prospectively recorded. At 12 months, 923 of 1,785 patients (51.7%) had discontinued treatment. Compared with continuers, drop-outs had a significantly lower age, a lower age at first dieting, lower dream BMI, a higher expected 1-year BMI loss, and a higher weight phobia. At logistic regression analysis, the strongest predictors of attrition at 12 months were lower age and higher expected 1-year BMI loss. The risk of drop-out increased systematically for unit increase in expected BMI loss at 12 months (hazard ratio, 1.12; 95% confidence interval, 1.04 to 1.20; p = 0.0018). The risk was particularly elevated in the first 6 months. Baseline weight loss expectations are independent cognitive predictors of attrition in obese patients entering a weight-losing program; the higher the expectations, the higher attrition at 12 months. Unrealistic weight goals should be tackled at the very beginning of treatment.
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I. Kirsch, G. Montgomery, and G. Sapirstein (1995) meta-analyzed 6 weight-loss studies comparing the efficacy of cognitive-behavior therapy (CBT) alone to CBT plus hypnotherapy and concluded that ''the addition of hypnosis substantially enhanced treatment outcome'' (p. 214). Kirsch reported a mean effect size(expressed as d) of 1.96. After correcting several transcription and computational inaccuracies in the original meta-analysis, these 6 studies yield a smaller mean effect size (.26). Moreover, if I questionable study is removed from the analysis, the effect sizes become more homogeneous and the mean (.21) is no longer statistically significant. It is concluded that the addition of hypnosis to CBT for weight loss results in, at most, a small enhancement of treatment outcome.
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Self-efficacy in relation to eating behavior for weight control is commonly defined as having the confidence to control urges to overeat in high-risk situations. Prior researchers have suggested that self-efficacy plays a mediating role in eating behavior for weight loss and maintenance. The current study examined the relationship between self-efficacy in resisting certain temptations and daily dietary intake at each meal. Participants were 83 men and 122 women registered at the health management website “Asken”. They administered questionnaires about self-efficacy and dietary records. As results of multiple regression analysis, self-efficacy in resisting negative emotions was negatively related to lunch energy intake in men (β = -0.308, p = 0.023) and total (β = -0.302, p = 0.003), breakfast (β = -0.334, p = 0.004), and snacking (β = -0.232, p = 0.022) energy intake in women. Also, self-efficacy in resisting rewards was negatively related to lunch energy intake in men (β = -0.218, p = 0.040). In men, self-efficacy in resisting hunger was positively related to protein intake (β = 0.148, p = 0.021) and relaxation was negatively related to lipid intake (β = -0.211, p = 0.009). Self-efficacy in resisting some temptations, especially negative emotions, and dietary intakes were negatively related. Future research is needed to confirm these results and assess the prospective effects of self-efficacy.
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Abstract This study compared the effectiveness of hypnobehavioral therapy (HypBe) and HypBe enhanced by elements of energetic psychotherapy (hypnoenergetic therapy, HypEn) for obese women. Sixty clients were randomized to either HypBe or HypEn. Body weight, BMI, eating behavior, and body concept were assessed at baseline, posttreatment, and at a follow-up. Mixed ANOVA models and effect sizes were used for statistics. Both treatments improved weight, BMI, eating behavior, and some aspects of body concept. Improvements in eating behavior and body concept were higher for those who also lost weight (responders). Weight and BMI reductions were not significantly different for the HypEn versus HypBe groups at follow-up.
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Psychosocial stress is an important precursor of disease and reduced quality of life in humans. The biological pathways between stress exposure and pathophysiological processes underlying disease have received substantial scientific attention, although the roles of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system remain insufficiently understood. Recent attention has focused on chronic systemic low-grade inflammation as a promising pathway because elevated inflammation often accompanies chronic psychosocial distress. These alterations of inflammatory activity play a key role in the pathophysiology of diseases that are adversely affected by chronic distress, such as cardiovascular disease. Transient increases in systemic inflammation are observed in response to acute psychosocial stress, with larger responses among individuals reporting adverse psychosocial states or conditions such as depression, lower self-esteem, or lower self-compassion. Recent evidence shows that lower subjective social status and perceived purpose in life are associated with sensitization of inflammatory stress responses to repeated stress exposure. The aims of this selective review article are to summarize current knowledge of the role of acute and chronic psychosocial stress on low-grade inflammation in humans and to discuss potential relationships between inflammatory responses to acute psychosocial stress and long-term development of disease.
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Objective: To characterize health-related quality of life (HRQL) impairment in severely obese subjects, using several validated instruments. Methods: A cross-sectional analysis of 500 severely obese subjects was completed. Short-Form (SF)-12 [Physical (PCS) and Mental (MCS) component summary scores], EuroQol (EQ)-5D [Index and Visual Analog Scale (VAS)], and Impact of Weight on Quality of Life (IWQOL)-Lite were administered. Multivariable linear regression models were performed to identify independent predictors of HRQL. Results: Increasing BMI was associated with lower PCS (-1.33 points per 5 kg/m(2) heavier; P < 0.001), EQ-index (-0.02; P < 0.001), EQ-VAS (-1.71; P = 0.003), and IWQOL-Lite (-3.72; P = 0.002), but not MCS (P = 0.69). The strongest predictors (all P < 0.005) for impairment in each instrument were: fibromyalgia for PCS (-5.84 points), depression for MCS (-7.49 points), stroke for EQ-index (-0.17 points), less than full-time employment for EQ-VAS (-7.06 points), and coronary disease for IWQOL-Lite (-10.86 points). Chronic pain, depression, and sleep apnea were associated with reduced HRQL using all instruments. Conclusion: The clinical impact of BMI on physical and general HRQL was small, and mental health scores were not associated with BMI. Chronic pain, depression, and sleep apnea were consistently associated with lower HRQL.
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Investigated depth of trance and the components of susceptibility (the Harvard Group Scale of Hypnotic Susceptibility—Form A) as outcome variables in 47 female patients in a weight-reduction program involving hypnosis and in 46 program dropouts. Significant reductions were found in measures of anthropometry following treatment. A significant depth of trance effect was found between patients and dropouts and significantly more weight was lost by high- than low-susceptible Ss. Significant correlations were found between weight loss and general ideomotor and challenge susceptibility. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Investigated the effects of hypnosis for weight control. Hypnotizability was assessed by the Stanford Hypnotic Susceptibility Scale—Form C (SHSS—C). 45 female Ss completed the study with examiners who were blind with respect to hypnotizability scores. Ss exposed to a simple self-management technique and to the hypnosis intervention devised by D. Spiegel and H. Spiegel (1978), modified to include specific food aversion, lost significantly more weight at a 3-mo follow-up than Ss exposed only to the self-management treatment. The specificity of hypnosis in the program was supported by a significant correlation between weight loss and SHSS—C scores for the same group. S attrition was about equal across all treatment groups, suggesting all treatments were perceived as active. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Chapter
After a short review of the research literature for hypnosis in obesity, a practical and commonsense overview of the problem is presented. Research data clearly shows that the addition of hypnosis substantially enhances treatment outcome, especially for the long term. The author further describes his hypnotherapeutic approach containing, among others, behavioural, cognitive and interactional components. However, for a considerable group of patients, weight reduction is not a realistic goal, and the aim of the treatment should be adapted accordingly to the needs of the individual patient. Hence some patients need to learn to accept themselves as overweight, instead of pursuing weight reduction.
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This paper presents a parameter covariance matrix estimator which is consistent even when the disturbances of a linear regression model are heteroskedastic. This estimator does not depend on a formal model of the structure of the heteroskedasticity. By comparing the elements of the new estimator to those of the usual covariance estimator, one obtains a direct test for heteroskedasticity, since in the absence of heteroskedasticity, the two estimators will be approximately equal, but will generally diverge otherwise. The test has an appealing least squares interpretation.
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
Hypnotic suggestibility has been described as a powerful predictor of outcomes associated with hypnotic interventions. However, there have been no systematic approaches to quantifying this effect across the literature. This meta-analysis evaluates the magnitude of the effect of hypnotic suggestibility on hypnotic outcomes in clinical settings. PsycINFO and PubMed were searched from their inception through July 2009. Thirty-four effects from 10 studies and 283 participants are reported. Results revealed a statistically significant overall effect size in the small to medium range (r = .24; 95% Confidence Interval = -0.28 to 0.75), indicating that greater hypnotic suggestibility led to greater effects of hypnosis interventions. Hypnotic suggestibility accounted for 6% of the variance in outcomes. Smaller sample size studies, use of the SHCS, and pediatric samples tended to result in larger effect sizes. The authors question the usefulness of assessing hypnotic suggestibility in clinical contexts.
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This article describes a substantial update to mvis, which brings it more closely in line with the feature set of S. van Buuren and C. G. M. Oudshoorn's implementation of the MICE system in R and S-PLUS (for details, see http://www.multiple-imputation.com). To make a clear distinction from mvis, the principal program of the new Stata release is called ice. I will give details of how to use the new features and a practical illustrative example using real data. All the facilities of mvis are retained by ice. Some improvements to micombine for computing estimates from multiply imputed datasets are also described.
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A questionnaire is presented for evaluating energy expenditure in leisure time physical activity (LTA), along with information about its validity. Administered by trained interviewers, the Minnesota LTA questionnaire is valid for use in longitudinal studies in North America of the relationship of physical activity to disease, in weight control clinics, and in other researches in which leisure time physical activity is of interest.
Article
Investigated the effects of hypnosis as a treatment for weight loss among women. The sample consisted of 60 women (aged 20–65 yrs) who were at least 20% overweight and were not in any other treatment program. Six client variables (suggestibility, self-concept, quality of family origin, age of obesity onset, education level, and socioeconomic status [SES]) and 1 process variable (multimodal imagery) were analyzed in relation to the dependent variable (weight loss). Two experimental groups, hypnosis plus audiotapes and hypnosis without audiotapes, and the control group were investigated for weight loss immediately after treatment and again after a 6-mo follow-up. The primary hypothesis that hypnosis is an effective treatment for weight loss was confirmed, but the 7 concomitant variables and the use of audiotapes were not significant contributors to weight loss. (26 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The steady-state basal plasma glucose and insulin concentrations are determined by their interaction in a feedback loop. A computer-solved model has been used to predict the homeostatic concentrations which arise from varying degrees beta-cell deficiency and insulin resistance. Comparison of a patient's fasting values with the model's predictions allows a quantitative assessment of the contributions of insulin resistance and deficient beta-cell function to the fasting hyperglycaemia (homeostasis model assessment, HOMA). The accuracy and precision of the estimate have been determined by comparison with independent measures of insulin resistance and beta-cell function using hyperglycaemic and euglycaemic clamps and an intravenous glucose tolerance test. The estimate of insulin resistance obtained by homeostasis model assessment correlated with estimates obtained by use of the euglycaemic clamp (Rs = 0.88, p less than 0.0001), the fasting insulin concentration (Rs = 0.81, p less than 0.0001), and the hyperglycaemic clamp, (Rs = 0.69, p less than 0.01). There was no correlation with any aspect of insulin-receptor binding. The estimate of deficient beta-cell function obtained by homeostasis model assessment correlated with that derived using the hyperglycaemic clamp (Rs = 0.61, p less than 0.01) and with the estimate from the intravenous glucose tolerance test (Rs = 0.64, p less than 0.05). The low precision of the estimates from the model (coefficients of variation: 31% for insulin resistance and 32% for beta-cell deficit) limits its use, but the correlation of the model's estimates with patient data accords with the hypothesis that basal glucose and insulin interactions are largely determined by a simple feed back loop.
Article
This study examined the effect of adding hypnosis to a behavioral weight-management program on short- and long-term weight change. One hundred nine subjects, who ranged in age from 17 to 67, completed a behavioral treatment either with or without the addition of hypnosis. At the end of the 9-week program, both interventions resulted in significant weight reduction. However, at the 8-month and 2-year follow-ups, the hypnosis clients showed significant additional weight loss, while those in the behavioral treatment exhibited little further change. More of the subjects who used hypnosis also achieved and maintained their personal weight goals. The utility of employing hypnosis as an adjunct to a behavioral weight-management program is discussed.
Article
The study describes a program of time-limited, relatively un-contaminated hypnotherapy for the treatment of obesity, and explores relationships between degree of objectively measured hypnotizability (by the Stanford Hypnotic Susceptibility Scale, Form A of Weitzenhoffer and E. R. Hilgard, 1959) and success at weight reduction via hetero- and self-hypnosis. Of the 43 male and female adult outpatients of the Morton Prince Center for Hypnotherapy in New York City who entered the program, 30 Ss completed the orientation session, 8 weekly individual treatment sessions, and 12 weeks of follow-up, during which self-hypnosis was practiced. These Ss showed an average weight loss of 20.2 pounds. Results indicated a statistically significant positive association between degree of hypnotizability and success at weight reduction. High hypnotizable Ss were significantly more aided by the treatment program than either medium hypnotizable or low hypnotizable Ss.
Article
The ability to look upward on signal while closing the eyelids (Eye Roll Sign) correlates highly (73.9%) with hypnotic trance capacity as measured by the Hypnotic Induction Profile in 2000 consecutive psychotherapy cases. In practical clinical terms this implies that in about five seconds the Eye Roll (ER) sign predicts hypnotizability in three out of four cases. Further, the higher the roll (0–4 scale), the higher is the trance capacity. This offers a quick, subtle, clinical way to ascertain whether or not hypnosis can have a probable role as an adjunct in the various psychotherapeutic strategies. Technic and data are presented.
Article
This is an account of further work on a rating scale for depressive states, including a detailed discussion on the general problems of comparing successive samples from a ‘population’, the meaning of factor scores, and the other results obtained. The intercorrelation matrix of the items of the scale has been factor-analysed by the method of principal components, which were then given a Varimax rotation. Weights are given for calculating factor scores, both for rotated as well as unrotated factors. The data for 152 men and 120 women having been kept separate, it is possible to compare the two sets of results. The method of using the rating scale is described in detail in relation to the individual items.
Article
The purpose of this study was to conduct an assessment of binge eating severity among obese persons. Two questionnaires were developed. A 16-item Binge Eating Scale was constructed describing both behavioral manifestations (e.g., eating large amounts of food) and feeling/cognitions surrounding a binge episode (e.g., guilt, fear of being unable to stop eating). An 11-item Cognitive Factors Scale was developed measure two cognitive phenomena thought to be related to binge eating: the tendency to set unrealistic standards for a diet (e.g., eliminating "favorite foods") and low efficacy expectations for sustaining a diet. The results showed that the Binge Eating Scale successfully discriminated among persons judged by trained interviewers to have either no, moderate or severe binge eating problems. Significant correlation between the scales were obtained such that severe bingers tended to set up diets which were unrealistically strict while reporting low efficacy expectations to sustain a diet. The discussion highlighted the differences among obese persons on binge eating severity and emphasized the role of cognitions in the relapse of self control of eating.
Article
There is a great demand for perceptual effort ratings in order to better understand man at work. Such ratings are important complements to behavioral and physiological measurements of physical performance and work capacity. This is true for both theoretical analysis and application in medicine, human factors, and sports. Perceptual estimates, obtained by psychophysical ratio-scaling methods, are valid when describing general perceptual variation, but category methods are more useful in several applied situations when differences between individuals are described. A presentation is made of ratio-scaling methods, category methods, especially the Borg Scale for ratings of perceived exertion, and a new method that combines the category method with ratio properties. Some of the advantages and disadvantages of the different methods are discussed in both theoretical-psychophysical and psychophysiological frames of reference.
Article
Identical suggestions for the control of obesity were administered to a group receiving hypnotic induction and a group receiving task-motivational instructions. A no-treatment control group was also included. The only significant finding was greater weight loss by Ss in the task-motivational group than Ss in the control group. Much of the difference was attributed to weight gain of Ss in the control group. Within groups, highly suggestible Ss lost more weight in the hypnotic group, while suggestibility was unrelated to weight loss in the task-motivational group. The possibility that task-motivational and hypnotic Ss approached treatment with different mental sets and expectations was discussed. The role of hypnotizability in the hypnotic treatment of obesity was discussed.
Article
A meta-analysis was performed on 18 studies in which a cognitive-behavioral therapy was compared with the same therapy supplemented by hypnosis. The results indicated that the addition of hypnosis substantially enhanced treatment outcome, so that the average client receiving cognitive-behavioral hypnotherapy showed greater improvement than at least 70% of clients receiving nonhypnotic treatment. Effects seemed particularly pronounced for treatments of obesity, especially at long-term follow-up, indicating that unlike those in nonhypnotic treatment, clients to whom hypnotic inductions had been administered continued to lose weight after treatment ended. These results were particularly striking because of the few procedural differences between the hypnotic and nonhypnotic treatments.
Article
In a 3rd meta-analysis of the effect of adding hypnosis to cognitive-behavioral treatments for weight reduction, additional data were obtained from authors of 2 studies, and computational inaccuracies in both previous meta-analyses were corrected. Averaged across posttreatment and follow-up assessment periods, the mean weight loss was 6.00 lbs. (2.72 kg) without hypnosis and 11.83 lbs. (5.37 kg) with hypnosis. The mean effect size of this difference was 0.66 SD. At the last assessment period, the mean weight loss was 6.03 lbs. (2.74 kg) without hypnosis and 14.88 lbs. (6.75 kg) with hypnosis. The effect size for this difference was 0.98 SD. Correlational analyses indicated that the benefits of hypnosis increased substantially over time (r = .74).
Article
I. Kirsch, G. Montgomery, and G. Sapirstein (1995) meta-analyzed 6 weight-loss studies comparing the efficacy of cognitive-behavior therapy (CBT) alone to CBT plus hypnotherapy and concluded that "the addition of hypnosis substantially enhanced treatment outcome" (p.214). Kirsch reported a mean effect size (expressed as d) of 1.96. After correcting several transcription and computational inaccuracies in the original meta-analysis, these 6 studies yield a smaller mean effect size (.26). Moreover, if 1 questionable study is removed from the analysis, the effect sizes become more homogeneous and the mean (.21) is no longer statistically significant. It is concluded that the addition of hypnosis to CBT for weight loss results in, at most, a small enhancement of treatment outcome.
Article
The relationship between perceived overqualification and psychological well-being was explored within the framework of stress-illness models, using multiple regression analysis. Data were collected from 179 male and 109 female members of a local midwestern chapter of the American Postal Workers Union. As expected, there was a significant, positive relationship between perceived overqualification and psychological well-being: The greater the perceived overqualification, the greater the psychological distress. The interaction between perceived overqualification and gender was not significant.
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There is mounting evidence that inflammation plays a role in the development of coronary heart disease (CHD). Observations have been made linking the presence of infections in the vessel wall with atherosclerosis, and epidemiological data also implicate infection in remote sites in the aetiology of CHD. In this article we propose a key role for the proinflammatory cytokine interleukin-6 (IL-6) in several mechanisms that contribute to the development of CHD. IL-6 is a powerful inducer of the hepatic acute phase response. Elevated concentrations of acute phase reactants, such as C-reactive protein (CRP), are found in patients with acute coronary syndromes, and predict future risk in apparently healthy subjects. The acute phase reaction is associated with elevated levels of fibrinogen, a strong risk factor for CHD, with autocrine and paracrine activation of monocytes by IL-6 in the vessel wall contributing to the deposition of fibrinogen. The acute phase response is associated with increased blood viscosity, platelet number and activity. Furthermore, raised serum amyloid A lowers HDL-cholesterol levels. IL-6 decreases lipoprotein lipase (LPL) activity and monomeric LPL levels in plasma, which increases macrophage uptake of lipids. In fatty streaks and in the atheromatous 'cap' and 'shoulder' regions, macrophage foam cells and smooth muscle cells (SMC) express IL-6, suggesting a role for this cytokine along with interleukin-1 (IL-1) and tumour necrosis factor-alpha (TNF-alpha), in the progression of atherosclerosis. Both these cytokines induce the release of IL-6 from several cell types, including SMC. During vascular injury SMC are exposed to platelets or their products, and cytokine production by SMC further contributes to vascular damage. Furthermore, circulating IL-6 stimulates the hypothalamic-pituitary-adrenal (HPA) axis, activation of which is associated with central obesity, hypertension and insulin resistance. Thus we propose a role for IL-6 in the pathogenesis of CHD through a combination of autocrine, paracrine and endocrine mechanisms. This hypothesis lends itself to testing using interventions to influence IL-6 secretion and actions.
Article
Satiety ratings are often made using VAS or simple category scales. In order to establish a simple, more quantitative technique to index perceived hunger and/or fullness, research was undertaken to develop and test a labeled magnitude scale of satiety. Thirty-seven subjects rated the semantic meaning of 47 phrases describing different levels of hunger/fullness using magnitude estimation. Eleven phrases were then selected using criteria of response consistency, symmetry, bipolarity, and inclusion of the end-point anchors of 'greatest imaginable hunger (fullness)'. These phrases were placed along a vertical line scale at positions corresponding to their geometric mean magnitude estimates to create a labeled magnitude scale of satiety. This Satiety Labeled Intensity Magnitude (SLIM) scale was compared to VAS scales for sensitivity and reliability in two studies. In one image-based study, ANOVA with post-hoc tests showed the SLIM scale to have greater sensitivity and to have an average reliability coefficient of 0.90. In a second study using three different foods replicated on two consecutive weeks, reliability was found to be highest for the SLIM scale. It is concluded that the SLIM scale is a sensitive, reliable, and easy-to-use scale for measuring perceived satiety that has several advantages over other, more commonly used satiety scales.
Effectiveness of hypnosis as an adjunct to behavioral weight management
  • Bolocofsky
Manuale di Ipnosi Medica Rapida
  • G Regaldo
Regaldo G. Manuale di Ipnosi Medica Rapida. Turin, Italy: Giuseppe Regaldo; 2014.
International Handbook of Clinical Hypnosis
  • J Vanderlinden
Vanderlinden J. Hypnotherapy in obesity. In: Burrows GD, Stanley RO, Bloom PP, eds. International Handbook of Clinical Hypnosis. Chichester, UK: Wiley; 2001:221-232.