International Handbook of Clinical Hypnosis - E-Lib FK UWKS

HYPNOTHERAPY IN OBESITY 223
overlooked. Many reports display serious shortcomings in the description of
relevant patient characteristics, such as onset of obesity during childhood, youth or
adulthood), presence of individual psychopathology, past history of dieting, and
prior treatments. This strongly hampers the interpretation and comparison of
treatment results.
The most popular treatment seems to be the combination of a cognitivebehavioral
approach and hypnotherapy. In most of these studies, no relation
between hypnotizability and weight loss has been detected Aja, 1977; Cohen &
Alpert, 1978; Deyoub, 1978, 1979a,b; Kroger, 1970; Miller, 1974; Spiegel &
DeBetz, 1978; Stanton, 1975; Wadden & Flaxman, 1981). In contrast with these
®ndings, other researchers Anderson, 1985; Barabasz & Spiegel, 1989) have
shown a greater weight reduction in more highly hypnotizable patients. When
individual versus group therapy using hypnosis were compared, no difference in
weight reduction was found Collins, 1985); nor did the sex of the therapistÐmale
or femaleÐappear to have any in¯uence on weight reduction.
In a critical review, Wadden & Anderton 1982) stated that hypnosis can achieve
the same average weekly weight reduction as behavior therapy. They concluded
that hypnosis induction adds nothing essential to the treatment of obesity and that
`hypnosis does not appear to be of unique value for weight reduction'. This position
has since been refuted by several researchers. In three controlled comparative
surveys, a combination of behavioral therapy and hypnotherapy appeared to be
superior to a behavioral therapy approach for weight reduction and this lasted in a
follow-up after 3 months Barabasz & Spiegel, 1989), after 6 months Cochrane &
Friesen, 1986) and after 2 years Bolokofsky, Spinler & Coulthard-Morris, 1985).
Moreover, Kirsch, Montgomery & Sapirstein 1995) recently performed a metaanalysis
on a series of studies in which cognitive-behavioral therapy was compared
with the same therapy supplemented by hypnosis. The results clearly indicated that
the addition of hypnosis substantially enhanced treatment outcome. Effects seemed
particularly pronounced in obesity, especially at long-term follow-up, indicating
that unlike those in nonhypnotic treatment, clients to whom hypnotic inductions
had been administered continued to lose weight after treatment was ended. The
authors conclude that these results were particularly striking because of the few
procedural differences between the hypnotic and nonhypnotic treatments. These
results are encouraging and can hopefully stimulate more therapists to incorporate
hypnotic techniques in their treatment of obesity.
In most studies, the hypnotherapeutic techniques employed were very simple.
Barabasz & Spiegel 1989) taught the patients a self-hypnosis exercise and, for the
rest, made use only of the Spiegel & Spiegel procedure 1978), such as recommended
in stopping smoking behavior: `overeating is harmful to your health and
poisons your body'. Bolokovsky, Spinler & Coulthard-Morris 1985) also taught
self-hypnosis and suggested during the trance that their patients should respect the
agreements made on their eating behavior and weight. Cochrane & Friesen 1986)
developed a much more comprehensive program in three phases: in the ®rst phase,