Efficacy of Dialectical Behavior Therapy on Decreasing Weight in Obese Women with Emotional and Behavioral Disorders: A Quasi Experimental Study

Homayounpour, Parisa; Seirafi, Mohammadreza; Ghare, Sahar

doi:10.18502/ijdo.v13i1.5750

Volume 13, Issue 1 (volume 13, number 1 2021) IJDO 2021, 13(1): 48-56 | Back to browse issues page

‎ 10.18502/ijdo.v13i1.5750

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Homayounpour P, Seirafi M, Ghare S. Efficacy of Dialectical Behavior Therapy on Decreasing Weight in Obese Women with Emotional and Behavioral Disorders: A Quasi Experimental Study. IJDO 2021; 13 (1) :48-56
URL: http://ijdo.ssu.ac.ir/article-1-611-en.html

Efficacy of Dialectical Behavior Therapy on Decreasing Weight in Obese Women with Emotional and Behavioral Disorders: A Quasi Experimental Study

Parisa Homayounpour

, Mohammadreza Seirafi ^*

, Sahar Ghare

Associate Professor, Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran

Abstract: (1265 Views)

Objective: The growing worldwide prevalence of overweight and obesity, despite treatment strategies remain the health problem. Over the past decade, increasing attention has been paid to psychological factors and a potentially comprehensive, multimodal skills-based treatment. The purpose of this study was to evaluate the efficacy of dialectical behavior therapy (DBT) on weight loss in obese women with emotional and behavioral disorders.
Materials and Methods: In this quasi-experimental study, statistical population from convenience sampling consisted of 42 obese women with body mass index (BMI) more than 29.9 kg/m² divided in 3 groups, behavioral, emotional and control. Descriptive and analytic statistics were computed according to demographic information, emotional eating scale and Dutch eating behavior questionnaire. Intervention included 13 sessions of 1.5hr group therapy, DBT-skills training from April to September 2019. Mixed-effect modeling ANOVA with repeated measurements was performed by statistical analyses, IBM SPSS version 24 to study changes in variables over time.
Results: The results demonstrated that the emotional such as anger, anxiety and depression, significantly decrease during the study period. (P-value<0.001) As well as behavioral eating demonstrated significant improvement in restrained eating and decrease in emotional and external eating behaviors right after the end of intervention while trial group experienced significant weight loss.
Conclusion: The present study provides some evidence that DBT-skills training can be effective in decreasing problematic eating behaviors, emotion dysregulations, decreasing BMI

Keywords: Dialectical behavior therapy, Obesity, BMI, Behavior eating, Emotional eating

Full-Text [PDF 178 kb] (458 Downloads)

Type of Study: Research | Subject: Special
Received: 2021/03/13 | Accepted: 2021/03/20 | Published: 2021/03/20

References

1. Gadde KM, Martin CK, Berthoud HR, Heymsfield SB. Obesity: pathophysiology and management. Journal of the American College of Cardiology. 2018;71(1):69-84. [DOI:10.1016/j.jacc.2017.11.011]

2. Ou XH, Zhu CC, Sun SC. Effects of obesity and diabetes on the epigenetic modification of mammalian gametes. Journal of cellular physiology. 2019;234(6):7847-55. [DOI:10.1002/jcp.27847]

3. Jordan CH, Wang W, Donatoni L, Meier BP. Mindful eating: Trait and state mindfulness predict healthier eating behavior. Personality and Individual differences. 2014;68:107-11. [DOI:10.1016/j.paid.2014.04.013]

4. Lyon HN, Hirschhorn JN. Genetics of common forms of obesity: a brief overview-. The American journal of clinical nutrition. 2005;82(1):215S-7S. [DOI:10.1093/ajcn/82.1.215S]

5. Bray GA, DeLany J. Opinions of obesity experts on the causes and treatment of obesity‐A new survey. Obesity research. 1995;3(S4):419S-23S. [DOI:10.1002/j.1550-8528.1995.tb00208.x]

6. Ang YN, Wee BS, Poh BK, Ismail MN. Multifactorial influences of childhood obesity. Current Obesity Reports. 2013;2(1):10-22. [DOI:10.1007/s13679-012-0042-7]

7. Wilding J. Are the causes of obesity primarily environmental? Yes. Bmj. 2012;345. [DOI:10.1136/bmj.e5843]

8. Narciso J, Silva AJ, Rodrigues V, Monteiro MJ, Almeida A, Saavedra R, et al. Behavioral, contextual and biological factors associated with obesity during adolescence: A systematic review. PloS one. 2019;14(4):e0214941. [DOI:10.1371/journal.pone.0214941]

9. Bourdier L, Orri M, Carre A, Gearhardt AN, Romo L, Dantzer C, Berthoz S. Are emotionally driven and addictive-like eating behaviors the missing links between psychological distress and greater body weight?. Appetite. 2018;120:536-46. [DOI:10.1016/j.appet.2017.10.013]

10. Jarvelä-Reijonen E, Karhunen L, Sairanen E, Muotka J, Lindroos S, Laitinen J, et al. The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity. 2018;15(1):1-4. [DOI:10.1186/s12966-018-0654-8]

11. Antoniou EE, Bongers P, Jansen A. The mediating role of dichotomous thinking and emotional eating in the relationship between depression and BMI. Eating behaviors. 2017;26:55-60. [DOI:10.1016/j.eatbeh.2017.01.007]

12. Contreras-Rodriguez O, Martin-Perez C, Vilar-Lopez R, Verdejo-Garcia A. Ventral and dorsal striatum networks in obesity: link to food craving and weight gain. Biological psychiatry. 2017;81(9):789-96. [DOI:10.1016/j.biopsych.2015.11.020]

13. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. International journal of obesity. 2008;32(9):1431-7. [DOI:10.1038/ijo.2008.102]

14. Naets T, Vervoort L, Tanghe A, De Guchtenaere A, Braet C. Maladaptive Eating in Children and Adolescents With Obesity: Scrutinizing Differences in Inhibition. Frontiers in Psychiatry. 2020;11. [DOI:10.3389/fpsyt.2020.00309]

15. Wansink B. Nutritional gatekeepers and the 72% solution. Journal of the American Dietetic Association. 2006;106(2006):1324-7. [DOI:10.1016/j.jada.2006.07.023]

16. Bruch H. Obesity and orality. Contemporary Psychoanalysis. 1969;5(2):129-44. [DOI:10.1080/00107530.1969.10745153]

17. Dube L, Menon K. Multiple roles of consumption emotions in post‐purchase satisfaction with extended service transactions. International Journal of Service Industry Management. 2000. [DOI:10.1108/09564230010340788]

18. Van Strien T. Causes of emotional eating and matched treatment of obesity. Current diabetes reports. 2018;18(6):1-8. [DOI:10.1007/s11892-018-1000-x]

19. Ouwens MA, van Strien T, van Leeuwe JF. Possible pathways between depression, emotional and external eating. A structural equation model. Appetite. 2009;53(2):245-8. [DOI:10.1016/j.appet.2009.06.001]

20. Van Strien T. Causes of emotional eating and matched treatment of obesity. Current diabetes reports. 2018;18(6):1-8. [DOI:10.1007/s11892-018-1000-x]

21. Schneider KL, Appelhans BM, Whited MC, Oleski J, Pagoto SL. Trait anxiety, but not trait anger, predisposes obese individuals to emotional eating. Appetite. 2010;55(3):701-6. [DOI:10.1016/j.appet.2010.10.006]

22. Glisenti K, Strodl E. Cognitive behavior therapy and dialectical behavior therapy for treating obese emotional eaters. Clinical Case Studies. 2012;11(2):71-88. [DOI:10.1177/1534650112441701]

23. Arnow B, Kenardy J, Agras WS. The Emotional Eating Scale: The development of a measure to assess coping with negative affect by eating. International Journal of Eating Disorders. 1995;18(1):79-90. https://doi.org/10.1002/1098-108X(199507)18:1<79::AID-EAT2260180109>3.0.CO;2-V [DOI:10.1002/1098-108X(199507)18:13.0.CO;2-V]

24. Evers C, Adriaanse M, de Ridder DT, de Witt Huberts JC. Good mood food. Positive emotion as a neglected trigger for food intake. Appetite. 2013;68:1-7. [DOI:10.1016/j.appet.2013.04.007]

25. Gianini LM, White MA, Masheb RM. Eating pathology, emotion regulation, and emotional overeating in obese adults with binge eating disorder. Eating behaviors. 2013;14(3):309-13. [DOI:10.1016/j.eatbeh.2013.05.008]

26. Topham GL, Hubbs-Tait L, Rutledge JM, Page MC, Kennedy TS, Shriver LH, Harrist AW. Parenting styles, parental response to child emotion, and family emotional responsiveness are related to child emotional eating. Appetite. 2011;56(2):261-4. [DOI:10.1016/j.appet.2011.01.007]

27. Sim DE, Strong DR, Manzano M, Eichen DM, Rhee KE, Tanofsky-Kraff M, et al. Evaluating psychometric properties of the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) in a clinical sample of children seeking treatment for obesity: a case for the unidimensional model. International Journal of Obesity. 2019;43(12):2565-72. [DOI:10.1038/s41366-019-0427-8]

28. Smyth JM, Wonderlich SA, Heron KE, Sliwinski MJ, Crosby RD, Mitchell JE, et al. Daily and momentary mood and stress are associated with binge eating and vomiting in bulimia nervosa patients in the natural environment. Journal of consulting and clinical psychology. 2007;75(4):629. [DOI:10.1037/0022-006X.75.4.629]

29. Valentine SE, Bankoff SM, Poulin RM, Reidler EB, Pantalone DW. The use of dialectical behavior therapy skills training as stand‐alone treatment: A systematic review of the treatment outcome literature. Journal of clinical psychology. 2015;71(1):1-20. [DOI:10.1002/jclp.22114]

30. Roosen MA, Safer D, Adler S, Cebolla A, & Van Strien T. Group dialectical behavior therapy adapted for obese emotional eaters; a pilot study. Nutricion hospitalaria. 2012; 27(4), 1141-1147.

31. Safer DL, Adler S, Masson PC. The DBT? Solution for Emotional Eating: A Proven Program to Break the Cycle of Bingeing and Out-of-Control Eating. Guilford Publications; 2018.

32. Safer DL, Jo B. Outcome from a randomized controlled trial of group therapy for binge eating disorder: Comparing dialectical behavior therapy adapted for binge eating to an active comparison group therapy. Behavior therapy. 2010;41(1):106-20. [DOI:10.1016/j.beth.2009.01.006]

33. Chen EY, Matthews L, Allen C, Kuo JR, Linehan MM. Dialectical behavior therapy for clients with binge‐eating disorder or bulimia nervosa and borderline personality disorder. International Journal of Eating Disorders. 2008;41(6):505-12. [DOI:10.1002/eat.20522]

34. Kamody RC, Thurston IB, Burton ET. Acceptance-based skill acquisition and cognitive reappraisal in a culturally responsive treatment for binge eating in adolescence. Eating disorders. 2020;28(2):184-201. [DOI:10.1080/10640266.2020.1731055]

35. Fitzpatrick S, Bailey K, Rizvi SL. Changes in Emotions Over the Course of Dialectical Behavior Therapy and the Moderating Role of Depression, Anxiety, and Posttraumatic Stress Disorder. Behavior Therapy. 2020;51(6):946-57. [DOI:10.1016/j.beth.2019.12.009]

36. Gratz KL, Tull MT. Emotion regulation as a mechanism of change in acceptance-and mindfulness-based treatments. Assessing mindfulness and acceptance processes in clients: Illuminating the theory and practice of change. 2010;2:107-33.

37. Neacsiu AD, Eberle JW, Kramer R, Wiesmann T, Linehan MM. Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behaviour research and therapy. 2014;59:40-51. [DOI:10.1016/j.brat.2014.05.005]

38. Cavicchioli M, Ramella P, Vassena G, Simone G, Prudenziati F, Sirtori F, et al. Dialectical behaviour therapy skills training for the treatment of addictive behaviours among individuals with alcohol use disorder: the effect of emotion regulation and experiential avoidance. The American journal of drug and alcohol abuse. 2020;46(3):368-84. [DOI:10.1080/00952990.2020.1712411]

39. Dol A, Kulyk O, Velthuijsen H, van Gemert-Pijnen L, van Strien T. Translating dialectic dialogues into persuasive coaching strategies for personalized virtual coach: a research protocol for emotional eaters. In12th International Conference, PERSUASIVE 2017, Amsterdam, The Netherlands, April 4-6, 2017: Persuasive Technology: Development and implementation of personalized technologies to change attitudes and behaviours 2017.

40. Fernandes J, Ferreira‐Santos F, Miller K, Torres S. Emotional processing in obesity: a systematic review and exploratory meta‐analysis. Obesity Reviews. 2018;19(1):111-20. [DOI:10.1111/obr.12607]

41. Flolo TN, Tell GS, Kolotkin RL, Aasprang A, Norekval TM, Vage V, et al. Eating self-efficacy as predictor of long-term weight loss and obesity-specific quality of life after sleeve gastrectomy: a prospective cohort study. Surgery for Obesity and Related Diseases. 2019;15(2):161-7. [DOI:10.1016/j.soard.2018.12.011]