Comparing the Effectiveness of Group Cognitive-Behavioral Therapy and Mindfullness-Based Stress Reduction Therapy on Body Image, Anxiety, and Overeating in Obese Women

Sartipi Yarahmadi, Mahnaz; Kordestani, Davood; Goodarzi, Kourosh; Rozbahani, Mehdi

Volume 12 - Articles-1401 MEJDS (2022) 12: 26 | Back to browse issues page

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Sartipi Yarahmadi M, Kordestani D, Goodarzi K, Rozbahani M. Comparing the Effectiveness of Group Cognitive-Behavioral Therapy and Mindfullness-Based Stress Reduction Therapy on Body Image, Anxiety, and Overeating in Obese Women. MEJDS 2022; 12 :26-26
URL: http://jdisabilstud.org/article-1-2344-en.html

Comparing the Effectiveness of Group Cognitive-Behavioral Therapy and Mindfullness-Based Stress Reduction Therapy on Body Image, Anxiety, and Overeating in Obese Women

Mahnaz Sartipi Yarahmadi¹

, Davood Kordestani ^*²

, Kourosh Goodarzi³

, Mehdi Rozbahani⁴

1- Department of Psychology,Borujerd Branch, Islamic Azad University
2- Department of Psychology,Borujerd Branch, Islamic Azad University;Department of Psychology, Payam Noor University, Tehran
3- Department of Psychology, Borujerd Branch, Islamic Azad University
4- Department of Motor Behavior, Borujerd Branch, Islamic Azad University

Abstract: (1199 Views)

Background & Objectives: Obesity can create physical and mental disabilities in social interactions and communication skills. One of the factors affecting obesity is body image, i.e., mental representation of body size, shape and form. Body image comprises cognitive, emotional and behavioral components. Also, obesity may cause anxiety. Overeating is another psychological factor that can affect obese women.
Cognitive–behavioral therapy is one of the treatment techniques that may positively affect the psychological status of obese women. Group cognitive–behavioral therapy is a type of psychotherapy that combines cognitive and learning theories with therapeutic techniques derived from cognitive therapy and group behavioral therapy. Another helpful therapy is mindfulness–based reduction stress therapy. It is one of the psychological approaches that may be effective in reducing psychological disorders in obese women. This study aimed to compare the effectiveness of these two stress reductive approaches on improving the body image, anxiety, and overeating among obese women.
Methods: The present research is a quasi–experimental study with a pretest–posttest and follow–up design with a control group. The statistical population included all obese women (n=492) referred to counseling centers in Malayer City, Iran, during 2018 and 2019. Of them, 45 women (3 groups of 15 women, including 2 experimental and 1 control groups) were selected as the study samples using the available non–random sampling method. The inclusion criteria for the study participants were having a body mass index of 30 or above, being interested in participating in the counseling course, and not receiving other psychological therapies (for the experimental groups). Subjects responded to the Multidimensional Body–Self Relations Questionnaire (MBSRQ) (Kash, 2000), Beck Anxiety Inventory (Beck et al., 1988), and Binge Eating Scale (Gormally et al., 1982) before and immediately after the intervention and then at the follow–up phase (three months after the intervention). One experimental group received group cognitive behavioral therapy (White, 2001) in eight 90–min sessions and the other experimental group underwent the mindfulness–based stress reduction program (Kabat–Zinn et al., 1992) in another eight 90–min sessions. For the control group, no intervention was presented. The study data were analyzed by descriptive (mean and standard deviation) and inferential statistics (repeated measures analysis of variance and LSD post hoc test) in SPSS software version 21. The significance level of statistical tests was considered at 0.05.
Results: The pretest mean scores of body image of the group cognitive–behavioral and mindfulness–based stress reduction therapies increased from 165.14 and 165.95 to 205.47 and 209.53 in the posttest, respectively. The follow–up mean scores of the body image for the group cognitive–behavioral and mindfulness–based stress reduction therapies were 205.5 and 204.47, respectively. Compared to the posttest scores, these scores show the stability of changes over time. The pretest mean scores of anxiety of the group cognitive–behavioral and mindfulness–based stress reduction therapies decreased from 44.73 and 46.16 to 33.53 and 36.33 in the posttest, respectively. The follow–up mean scores of the anxiety for the group cognitive–behavioral and mindfulness–based stress reduction therapies were 33.73 and 34.67, respectively. Compared to the posttest scores, these results show the stability of the outcomes over time. The pretest mean scores of the overeating of the group cognitive–behavioral and mindfulness–based stress reduction therapies decreased from 32.04 and 31.93 to 17.47 and 17.27 in the posttest, respectively. The follow–up mean scores of the overeating for the group cognitive–behavioral and mindfulness–based stress reduction therapies were 16.47 and 19.47, respectively. Also, compared to the posttest scores, these scores show the stability of the intervention effect over time. However, in all three variables of body image, anxiety and overeating, the mean scores of the control group did not change significantly between the pretest, posttest, and follow–up. The effects of time (p<0.001) and group (p<0.001) on all three variables of body image, anxiety, and overeating were significant. There were no significant differences between group cognitive–behavioral therapy and mindfulness–based stress reduction therapy regarding the variables of body image (p=0.662), anxiety (p=0.158), and overeating (p=0.201). Nevertheless, in all three dependent variables, significant differences were observed between the two experimental groups and the control group (p<0.001).
Conclusion: Based on the study results, group cognitive–behavioral therapy and mindfulness–based stress reduction therapy are both equally effective in improving psychological problems of obese women.

Keywords: Group cognitive–behavioral therapy, Mindfulness–Based stress reduction therapy, Anxiety, Overeating, Body image, Obese women

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Type of Study: Original Research Article | Subject: Psychology

References

1. Andolfi C, Fisichella PM. Epidemiology of obesity and associated comorbidities. J Laparoendosc Adv Surg Tech A. 2018;28(8):919–24. [DOI]

2. Janghorbani M, Amini M, Willett WC, Mehdi Gouya M, Delavari A, Alikhani S, et al. First nationwide survey of prevalence of overweight, underweight, and abdominal obesity in Iranian adults. Obesity. 2007;15(11):2797–808. [DOI]

3. Wang K, Liang R, Ma ZL, Chen J, Cheung EFC, Roalf DR, et al. Body image attitude among Chinese college students: body image attitude in college students. Psych J. 2018;7(1):31–40. [DOI]

4. Suelter CS, Schvey N, Kelly NR, Shanks M, Thompson KA, Mehari R, et al. Relationship of pressure to be thin with gains in body weight and fat mass in adolescents: pressure to be thin and weight gain. Pediatric Obesity. 2018;13(1):14–22. [DOI]

5. Spreckelsen P von, Glashouwer KA, Bennik EC, Wessel I, De Jong PJ. Negative body image: relationships with heightened disgust propensity, disgust sensitivity, and self-directed disgust. Plos One. 2018;13(6):e0198532. [DOI]

6. McLean RC, Morrison DS, Shearer R, Boyle S, Logue J. Attrition and weight loss outcomes for patients with complex obesity, anxiety and depression attending a weight management programme with targeted psychological treatment: HADS in weight management: attrition & weight loss. Clin Obes. 2016;6(2):133–42. [DOI]

7. O’Connor HT, Cook RL, Parker HM, Donges C, Franklin J, Steinbeck KS, et al. Influence of Omega-3 status on depression and anxiety in young women with obesity. Medicine & Science in Sports & Exercise. 2018;50(5S):251. [DOI]

8. Leme ACB, Thompson D, Lenz Dunker KL, Nicklas T, Tucunduva Philippi S, Lopez T, et al. Obesity and eating disorders in integrative prevention programmes for adolescents: protocol for a systematic review and meta-analysis. BMJ Open. 2018;8(4):e020381. [DOI]

9. Musetti A, Cattivelli R, Guerrini A, Mirto AM, Riboni FV, Varallo G, et al. Cognitive-behavioral therapy: current paths in the management of obesity. In: Şenormancı Ö, Şenormancı G; editors. Cognitive behavioral therapy and clinical applications. InTech; 2018. [DOI]

10. El Ghoch M, Bazzani PV, Calugi S, Dalle Grave R. Weight-loss cognitive-behavioural treatment and essential amino acid supplementation in a patient with spinal muscular atrophy and obesity. Case Reports in Medicine. 2018;2018:1–4. [DOI]

11. Pickert K. The mindful revolution [Internet]. 2014. [Article]

12. Kabat-Zinn J. Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice. 2003;10(2):144–56. [DOI]

13. Petroni ML, Caletti MT, Calugi S, Dalle Grave R, Marchesini G. Long-term treatment of severe obesity: are lifestyle interventions still an option? Expert Rev Endocrinol Metab. 2017;12(6):391–400. [DOI]

14. Quinn GP, Keough MJ. Experimental design and data analysis for biologists. First edition. Cambridge, UK: Cambridge University Press; 2002. [DOI]

15. Cash TF. The Multidimensional Body-Self Relations Questionnaire. The MBSRQ Users’ Manual 3rd Ed. 2000.

16. Cash TF. Body image: past, present, and future. Body Image. 2004;1(1):1–5. [DOI]

17. Zarshenas S, Karbalaaei Noori A, Hoseini SA, Rahgozar M, Seyednour R, Moshtagh N. The effects of aerobic exercise on body image attitudes in women. Archives of Rehabilitation. 2010;11(2):15–20. [Persian] [Article]

18. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893–7. [DOI]

19. Kaviani H, Mousavi AS. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran University Medical Journal. 2008;65(2):136–40. [Persian] [Article]

20. Gormally J, Black S, Daston S, Rardin D. The assessment of binge eating severity among obese persons. Addict Behav. 1982;7(1):47–55. [DOI]

21. Moloodi R, Dezhkam M, Moutabi F, Omidvar N. Comparison of early maladaptive schema in obese binge eaters and obese non-binge eaters. Journal of Behavioral Sciences. 2010;4(2):109–14. [Persian]

22. Kabat-Zinn J, Massion AO, Kristeller J, Peterson LG, Fletcher KE, Pbert L, et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry. 1992;149(7):936–43. [DOI]

23. Pourhosein R, Mousavi SA, Zare Moghaddam A, Gomnam A, Mirbelok Bozourgi A, Hasani F. Mindfulness from theory to therapy. Rooyesh-e-Ravanshenasi. 2019;8(1):155–69. [Persian]

24. White CA. Cognitive behaviour therapy for chronic medical problems: a guide to assessment and treatment in practice. Chichester, New York: John Wiley; 2001.

25. Farahzadi M, Madahi ME, Khalatbari J. Comparison the effectiveness of group therapy based on acceptance and commitment and cognitive-behavioral group therapy on the body image dissatisfaction and interpersonal sensitivity in women with the body image dissatisfaction. Research in Clinical Psychology and Counseling. 2017;7(2):69–89. [Persian] [Article]

26. Cassone S, Lewis V, Crisp DA. Enhancing positive body image: an evaluation of a cognitive behavioral therapy intervention and an exploration of the role of body shame. Eating Disorders. 2016;24(5):469–74. [DOI]

27. Norozi M, Mikaeeli Maniea F, Issazadegan A. Comparison of the effectiveness of cognitive behavioral group therapy and mindfulness and acceptance-based group therapy in the reduction of social anxiety disorder. Journal of Modern Psychological Researches. 2017;11(44):199–232. [Persian] [Article]

28. Salum GA, Petersen CS, Jarros RB, Toazza R, DeSousa D, Borba LN, et al. Group cognitive behavioral therapy and attention bias modification for childhood anxiety disorders: a factorial randomized trial of efficacy. J Child Adolesc Psychopharmacol. 2018;28(9):620–30. [DOI]

29. Khoshkerdar P, Raeisi Z. The effect of mindfulness-based stress reduction on affective control dimensions in adolescent girls with dysfunctional eating attitudes. Journal of Child and Family Studies. 2020;29(2). [DOI]

30. Alberts HJ, Thewissen R, Raes L. Dealing with problematic eating behavior: The effects of a mindfulness-based intervention on eating behavior, food cravings, dichotomous thinking and body image concern. Appetite. 2012;58(3):847–51. [DOI]

31. Baer RA, Fischer S, Huss DB. Mindfulness-based cognitive therapy applied to binge eating: a case study. Cogn Behav Pract. 2005;12(3):351–8. [DOI]