Why is Therapy of Overweight and Obesity Important?

Overweight and obesity raise the risk of morbidity from cardiovascular diseases (e. g., coronary artery disease, myocardial infarction, hypertensive heart disease, stroke, etc.), type 2 diabetes mellitus, dyslipidemia, respiratory problems, gallbladder disease, some forms of cancer, and osteoarthritis (Jensen et al. 2013).

Therapy for overweight and obesity

Overview

Treatment of overweight and obesity consists of general measures – like a (preferably life-long) change of eating habits using behaviour therapy, dietary therapy and a long-term increase of physical activity – and medical (pharmacotherapy, for example with sibutramine or orlistat) and surgical therapy, such as a reduction of the capacity of the stomach or a gastric bypass (Nammi et al. 2004).

Psychotherapy and medical hypnosis

Cognitive-behavioural therapy (CBT)

Cognitive-behavioural strategies include

(National Heart, Lung, and Blood Institute 1998).

Medical hypnosis

Treating obesity with a combination of hypnosis and CBT is considered an empirically supported psychological intervention (Chambless and Ollendick 2001). Adding hypnosis to cognitive-behavioural therapy substantially enhances the treatment outcome for obesity, even at 2-year follow-up (Kirsch et al. 1995).

Therapy plan for overweight and obesity

Psychotherapy of overweight and obesity includes cognitive-behavioural and hypnotherapeutic strategies. To give an overview of the therapy we exemplify a therapy plan below. The therapy is conducted in three phases 1) stabilization, 2) change, and 3) maintenance. The duration of each phase depends on the individual patient.

Cognitive-behavioural therapy

  • Self-monitoring of eating habits and physical activity
  • Education, especially about healthy eating habits and physical activity
  • Stress management (if indicated)
  • Problem solving
  • Cognitive restructuring

Hypnotherapy

Stabilisation Phase

  • Teaching self-hypnosis including favourite place of relaxation, muscle relaxation, ego strengthening

Change Phase

  • Slowing down the act of eating: time distortion (expansion of perceived time) and metaphorical approach (eating like a gourmet)
  • Eating with respect for the body
  • Pseudo-orientation in time
  • Enhance motivation for healthy eating habits and exercise

Maintenance Phase

  • Continue self-hypnosis, diet and exercise (including self-monitoring)
  • Hypnotherapeutic follow-up sessions to maintain achieved results

Literature:

Chambless DL, and Ollendick TH (2001) Empirically supported psychological interventions: Controversies and evidence. Annual review of psychology52 (1): 685-716

Kirsch I, Montgomery G and Sapirstein G (1995) Hypnosis as an adjunct to cognitive-behavioural psychotherapy: a meta-analysis. Journal of Consulting and clinical Psychology63(2), 214-220