International Handbook of Clinical Hypnosis - E-Lib FK UWKS

222 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
check on the possibility of weight loss. A higher metabolism is therefore
favorable in prognosis.
2. Regular movement and physical exercise increase metabolism and accelerate
weight loss through a series of mechanisms. Therefore physical exercise is an
absolute indication.
3. A minimal past history of attempted dieting increases the chances of successful
weight reduction. Obese patients with past histories of frequent and severe
dieting have a poor prognosis.
4. A fourth factor deals with the onset of the weight problems. If obesity
commences during childhood, this results mainly in an increase of the number
of fat cells and this appears to be irreversible and very unfavorable for
prognosis. On the other hand, subjects who develop obesity after adolescence
have a much better prognosis, since this has an in¯uence only on the size of the
fat cell, which is reversible.
5. A ®nal factor concerns the content of the diet. Patients going on a lowcarbohydrate
diet develop an irresistible urge for this sort of food sugar,
starch), which can then result in binges of all kinds of `forbidden food', a wellknown
phenomenon in dieting subjects. It is therefore important that carbohydrates
should be included in the diet in order to prevent relapse.
Apart from this, it should be mentioned that successful treatment correlates
favorably with long-term treatment, an experienced therapist, rigorous following of
the diet, physical exercise and sport, as well as cooperation of the family Bennet,
1986). The hypnotherapist should carefully assess the presence or absence of these
®ve prognostic factors and reckon with these data in planning the treatment. For a
considerable group of patients, this can mean that weight reduction is either not a
realistic goal, or that the aim of treatment should be adapted; for instance to learn
to accept themselves as overweight, instead of pursuing weight reduction.
RESEARCH ON HYPNOSIS
The literature on obesity has been swamped in recent years with very pessimistic
and negative treatment results, especially regarding the long-term outcome of
treatment Garner & Wooley, 1991). Unlike the situation with anorexia nervosa and
bulimia, hypnotherapists have been intensively engaged in the treatment of obesity
see Vanderlinden & Vandereycken, 1988). Many success stories have been
reported in the hypnotherapeutic literature, but these are often reports on a very
small number of patients. In addition, they deal with short-term treatment results,
and long-term follow-up data are almost completely lacking Mott & Roberts,
1979; Wadden & Anderton, 1982). Apart from this, most researchers use only one
criterion for evaluation, namely weight reduction, while alterations in psychological
characteristics such as body image, self-esteem and other criteria are totally