Research
Research and Professional Brief
Can Relaxation Training Reduce Emotional Eating in Women with Obesity? An Exploratory Study with 3 Months of Follow-Up

https://doi.org/10.1016/j.jada.2009.05.004Get rights and content

Abstract

Stress and negative emotions have been shown to be critical factors in inducing overeating as a form of maladaptive coping in some patients with obesity. We evaluated the efficacy of a 3-week relaxation protocol enhanced by virtual reality and portable mp3 players in reducing emotional eating in a sample of 60 female inpatients with obesity who report emotional eating, using a three-arm exploratory randomized controlled trial with 3 months of follow-up. The intervention included 12 individual relaxation training sessions provided traditionally (imagination condition) or supported by virtual reality (virtual reality condition). Control participants received only standard hospital-based care. Weight, behavior and psychological data were collected and analyzed. Relaxation training was effective in reducing emotional eating episodes, depressive and anxiety symptoms, and in improving perceived self-efficacy for eating control at 3-month follow-up after discharge. The virtual reality condition proved better than the imagination condition in the reduction of emotional eating. Weight decreased in subjects in all three conditions without significant differences between them, probably due to the common treatment all inpatients received. We conclude that relaxation training supported by new technologies could be a useful tool for reducing emotional eating episodes and thereby reducing weight and obesity.

Section snippets

Participants

Participants were recruited during a 7-month period during 2007 from an obese population admitted for weight reduction treatment at San Giuseppe Hospital, Istituto Auxologico Italiano, Verbania, Italy. Sixty women with obesity participated in the trial during the inpatient therapy (a flowchart of the procedures is shown in the Figure).

To be included in the study, patients had to be women; between ages 18 and 60 years; have received a primary diagnosis of obesity based on World Health

Statistical Analysis

Power analysis with α=.05 showed a statistical power of 0.80 and a total sample size of 51 to detect a large difference (f=0.45) between the three groups (virtual reality, imaginative condition, and control condition).

Normality of distributions was tested with Kolmogorov-Smirnov test, which showed the violation of the assumption for many variables in all three groups. Expecting to find large differences between each experimental group (virtual reality and imaginative condition) and the control

Results and Discussion

Postintervention results show that perceived self-efficacy for eating control (WELSQ) and depression (BDI) significantly improved in the virtual reality and imaginative condition experimental groups without significant difference between them. No significant change was found within the control group (18). Given the in-hospital final assessments, emotional eating episodes were obviously set to zero and weight significantly decreased within all three groups without significant difference among

Conclusions

Brief relaxation training enhanced by virtual reality and portable mp3 players appears to be an effective aid for treating obese female inpatients with emotional eating. Given this preliminary evidence, we believe that food and nutrition professionals should take into account stress management and coping improvement techniques for the treatment of individuals with obesity who report symptoms of emotional eating or binge eating disorder.

G. M. Manzoni is with Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy, and is a doctoral degree candidate, PhD Program in Clinical Psychology, University of Bergamo, Bergamo, Italy.

References (35)

  • R.W. Jeffery et al.

    Long-term maintenance of weight loss: Current status

    Health Psychol

    (2000)
  • N.D. Volkow et al.

    How can drug addiction help us understand obesity?

    Nat Neurosci

    (2005)
  • M. Lindeman et al.

    Emotional eating and eating disorder psychopathology

    Eat Disord

    (2001)
  • M.H. Bekker et al.

    Effects of negative mood induction and impulsivity on self-perceived emotional eating

    Int J Eat Disord

    (2004)
  • N.A. Troop

    Eating disorders as coping strategies: A critique

    Eur Eat Disord Rev

    (1998)
  • C.S. Carver et al.

    Assessing coping strategies: A theoretically based approach

    J Pers Soc Psychol

    (1989)
  • S. Popkess-Vawter et al.

    Overeating, reversal theory, and weight cycling

    West J Nurs Res

    (1998)
  • Cited by (85)

    • Technological Interventions for Eating and Weight Disorders

      2022, Comprehensive Clinical Psychology, Second Edition
    • Effect of acute high-intensity interval cycling while viewing a virtual natural scene on mood and eating behavior in men: A randomized pilot trial

      2019, Clinical Nutrition Experimental
      Citation Excerpt :

      It was reported that using VR alone increased tension, tiredness and lower energy level, but it reduced tiredness and enhanced enjoyment when it was paired with moderate-intensity cycling session [22]. It was recommended that VR condition showed better than the imagination condition in terms of decreasing of emotional eating for women as a part of reducing weight and obesity [29]. However, the exposure to real food enhances food craving to greater extent than VR food image stimuli, and the later enhances food craving to a greater extent than neutral cues [30].

    View all citing articles on Scopus

    G. M. Manzoni is with Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy, and is a doctoral degree candidate, PhD Program in Clinical Psychology, University of Bergamo, Bergamo, Italy.

    F. Pagnini is a doctoral degree candidate, PhD Program in Clinical Psychology, University of Bergamo, Bergamo, Italy.

    A. Gorini is with Istituto Auxologico Italiano IRCCS, Applied Technology for Neuro-Psychology Laboratory, Milan, Italy, and is a doctoral degree candidate, Research Institute Brain and Behaviour, Maastricht University, The Netherlands.

    A. Preziosa is with Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.

    G. Castelnuovo is with Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy, and with the Department of Psychology, Catholic University of Milan, Milan, Italy.

    E. Molinari is with Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy, and with the Department of Psychology, Catholic University of Milan, Milan, Italy.

    G. Riva is with Istituto Auxologico Italiano IRCCS, Applied Technology for Neuro-Psychology Laboratory, Milan, Italy, and with the Department of Psychology, Catholic University of Milan, Milan, Italy.

    View full text