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Outcome of Group Therapy for Body-Image Emotionality and Weight-Control Self-Efficacy

Published online by Cambridge University Press:  16 June 2009

Vivien J. Lewis
Affiliation:
Royal Shrewsbury Hospital Shelton
Alan J. Blair
Affiliation:
University of Birmingham
David A. Booth
Affiliation:
University of Birmingham

Extract

Long-term maintenance of weight loss is generally poor after clinical interventions, whether behavioural, cognitive-behavioural, dietary, pharmacological or surgical. This may be because self-assertion regarding body shape and self-efficacy in weight control are insufficiently encouraged in clients. Semi-structured group therapy sessions with written handouts were therefore designed to strengthen personal effectiveness and self-esteem. The therapy sessions also provided information about successful dieting behaviour, and encouragement of less switching between dieting strategies, less emotional eating, and more resistance to inappropriate social pressures. The clients were 24 women with a median (range) Body Mass Index of 28.9 (24.6–48.5) kg/m2, referred by their General Practitioners or self-referred. They participated in eight weekly therapeutic sessions in four groups and were followed up six months after the final session. There were large improvements during therapy in reported self-esteem, emotional overeating, personal effectiveness and self-efficacy, habit variation, and attitudes to body-size, improvements which were maintained at follow-up. In addition, there was a significant loss of body weight during therapy, with further loss observed at follow-up. Thus it is practicable to achieve marked reductions in professed problems with body image and eating control, changes that are theoretically necessary to empower clients to choose appropriate weight targets and to make progress towards them.

Type
Clinical Section
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1992

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References

Bandura, A. (1977). Self-efficacy: towards a unifying theory of behavioral change. Psychological Review 84, 191215.CrossRefGoogle Scholar
Bandura, A. (1986) Social Foundations of Thought and Action. Englewood Cliffs, N. J.: Prentice-Hall.Google Scholar
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders, New York: International Universities Press.Google Scholar
Bennett, G. A. (1986). Behavior therapy for obesity: a quantitative review of the effects of selected treatment characteristics on outcome. Behavior Therapy 17, 554562.CrossRefGoogle Scholar
Bennett, G. A. (1987). Behavior therapy in the treatment of obesity. In Boakes, R. A., Popplewell, D. A. and Burton, M. J. (Eds). Eating Habits. Chichester: Wiley.Google Scholar
Björntorp, P. (1987). The prevalence of obesity: complications related to distribution of surplus fat. In Bender, A. E. and Brookes, L. J. (Eds). Body Weight Control. Edinburgh: Churchill Livingstone.Google Scholar
Blair, A. J., Booth, D. A., Lewis, V. J. and Wainwright, C. J. (1989). The relative success of official and informal weight reduction techniques: retrospective correlational evidence. Psychology and Health 3, 195206.CrossRefGoogle Scholar
Blair, A. J., Lewis, V. J. and Booth, D. A. (1989). Behaviour therapy for obesity: the role of clinicians in the reduction of overweight. Counselling Psychology Quarterly 2, 289301.CrossRefGoogle Scholar
Blair, A. J., Lewis, V. J. and Booth, D. A. (1990). Does emotional eating interfere with success in attempts at weight control? Appetite 15, 151157.CrossRefGoogle ScholarPubMed
Blair, A. J., Lewis, V. J. and Booth, D. A. (1992). Response to leaflets about eating and shape by women concerned about their weight. Clinical report to be published in Behavioural Psychotherapy 20(3).Google Scholar
Booth, D. A. (1987). Cognitive experimental psychology of appetite. In Boakes, R. A., Popplewell, D. A. and Burton, M. J. (Eds). Eating Habits. Chichester: Wiley.Google Scholar
Booth, D. A., Lewis, V. J. and Blair, A. J. (1990). Dietary restraint and binge eating: pseudo-quantitative anthropology for a medicalised problem habit? Appetite 14, 116119.CrossRefGoogle ScholarPubMed
DiClemente, C. C., Prochaska, J. O. and Gilbertini, M. (1985). Self-efficacy and the stages of self-change in smoking. Cognitive Therapy and Research 9, 181200.CrossRefGoogle Scholar
Drewnowski, A., Riskey, D. and Desor, J. A. (1982). Feeling fat yet unconcerned: self-reported overweight and the restraint scale. Appetite 3, 273279.CrossRefGoogle ScholarPubMed
Edell, B. H., Edington, S., Herd, B., O'Brien, R. M. and Witkin, G. (1987). Self-efficacy and self-motivation as predictors of weight loss. Addictive Behaviors 12, 6366.CrossRefGoogle ScholarPubMed
Herman, C. P. (1978). Restrained eating. Psychiatric Clinics of North America 1, 593607.CrossRefGoogle Scholar
Herman, C. P. and Mack, D. (1975). Restrained and unrestrained eating. Journal of Personality 43, 647660.CrossRefGoogle ScholarPubMed
Herman, C. P. and Polivy, J. (1975). Anxiety, restraint, and eating behavior. Journal of Abnormal Psychology 84, 666672.CrossRefGoogle ScholarPubMed
Leon, G. R. and Chamberlain, K. (1973). Emotional arousal, eating patterns, and body image as differential factors associated with varying successes in maintaining a weight loss. Journal of Consulting and Clinical Psychology 40, 474480.CrossRefGoogle ScholarPubMed
Lewis, V. J. (1989). The percepts, attitudes and behaviour of dieting: causal structure of body weight control. University of Birmingham, PhD thesis.Google Scholar
Lewis, V. J. and Blair, A. J. (1991). The social context of eating disorders. In Cochrane, R. and Carroll, D. (Eds). Psychology and Social Issues. London: Falmer Press.Google Scholar
Lewis, V. J. and Booth, D. A. (1986). Causal influences within an individual's dieting thoughts, feelings and behaviour. In Diehl, J. M. and Leitzmann, C. (Eds). Measurement and Determinants of Food Habits. Wageningen: University Department of Human Nutrition.Google Scholar
Munro, J. F. and Ford, M. J. (1982). Drug treatment of obesity. In Silverstone, T. (Ed). Drugs and Appetite. London: Academic Press.Google Scholar
Novaco, R. W. (1977). Stress inoculation: a cognitive therapy for anger and its application in the case of depression. Journal of Consulting and Clinical Psychology 45, 600608.CrossRefGoogle ScholarPubMed
Orbach, S. (1978). Fat is a Feminist Issue: How to Lose Weight Permanently—Without Dieting. London: Arrow.Google Scholar
Orbach, S. (1986). Hunger Strike. London: Faber and Faber.Google Scholar
Polivy, J. and Herman, C. P. (1985). Dieting and bingeing: a causal analysis. American Psychologist 40, 193201.CrossRefGoogle ScholarPubMed
Quaade, F. (1981). Surgical treatment of obesity. In Björntorp, P., Cairella, M. and Howard, A. H. (Eds). Recent Advances in Obesity Research: III. London: John Libbey.Google Scholar
Rodin, J., Elias, M., Silberstein, L. R. and Wagner, A. (1988). Combined behavioral and pharmacologic treatment for obesity: predictors of successful weight maintenance. Journal of Consulting and Clinical Psychology 56, 399404.CrossRefGoogle ScholarPubMed
Ruderman, A. J. (1983). The restraint scale: a psychometric investigation. Behaviour Research and Therapy 21, 253258.CrossRefGoogle Scholar
Ruderman, A. J. (1986). Dietary restraint: a theoretical and empirical review. Psychological Bulletin 99, 247262.CrossRefGoogle ScholarPubMed
Sjoberg, L. and Persson, L.-O. (1979). A study of attempts by obese patients to regulate eating. Addictive Behaviors 4, 349359.CrossRefGoogle ScholarPubMed
Stunkard, A. J (1980). Psychoanalysis and psychotherapy. In Stunkard, A. J. (Ed). Obesity. Philadelphia: Saunders.Google ScholarPubMed
Stunkard, A. J. (1987). Behaviour therapy for obesity. In Bender, A. E. and Brookes, L. J. (Eds). Body Weight Control. Edinburgh: Churchill Livingstone.Google Scholar
Taal, E. and Seydel, E. (1988). The role of self-efficacy and health beliefs in health.Poster presented at the International conference on Health Psychology,Trier, FDR.Google Scholar
Taylor, C. B., Bandura, A., Ewart, C. K., Miller, N. H. and DeBusk, R. F. (1985). Exercise testing to enhance wives' confidence in their husbands' capabilities soon after clinically uncomplicated acute myocardial infarction. American Journal of Cardiology 55, 635638.CrossRefGoogle ScholarPubMed
Tuschl, R. J., Laessle, R. G., Platte, P. and Pirke, K.-M. (1990). Differences in foodchoice frequencies between restrained and unrestrained eaters. Appetite 14, 913.CrossRefGoogle ScholarPubMed
Van Itallie, T. B. (1980). Dietary approaches to the treatment of obesity. In Stunkard, A. J. (Ed). Obesity. Philadelphia: Saunders.Google ScholarPubMed
Van Strien, T., Frijters, J. E. R., Roosen, R. G. F. M., Knuiman-Hijl, W. J. and Defares, P. B. (1985). Eating behavior, personality traits and body mass in women. Addictive Behaviors 10, 333343.CrossRefGoogle ScholarPubMed
Wardle, J. (1987). Eating style: a validation study of the Dutch eating behavior questionnaire in normal subjects and women with eating disorders. Journal of Psychosomatic Research 31, 161169.CrossRefGoogle Scholar
Weinberg, R. S., Hughes, S. S., Critelli, J. W., England, R. and Jackson, A. (1984). Effects of preexisting and manipulated self-efficacy on weight loss in a self-control program. Journal of Research in Personality 18, 353358.CrossRefGoogle Scholar
Wirth, A. (1987). The role of exercise in weight control. In Bender, A. E. and Brookes, L. J. (Eds). Body Weight Control. Edinburgh: Churchill Livingstone.Google Scholar
Wooley, S. C. and Wooley, O. W. (1984). Should obesity be treated at all? Association for Research into Nervous and Mental Disease 62, 185192.Google ScholarPubMed
Zirkel, K. (1984). Assertiveness training and weight control. In Storlie, J. and Jordan, H. A. (Eds). Behavioral Management of Obesity. New York: Spectrum.Google Scholar
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