Group Mindfulness-Based Cognitive Therapy on Weight, Body Image, and Self-Esteem in Obese Individuals

Obesity is a metabolic disorder, characterized by increased body fat, as an essential risk factor for different diseases. A critical problem in obese individuals is overweight. Obesity is associated with less vitality, anxiety, depression, suicidal ideation, fatigue, and mood swings. Besides, obesity generally adversely impacts health and quality of life in individuals. Another issue encountered by individuals with obesity is low self–esteem. Defects in body image are also among the most common psychological problems in overweight subjects. A treatment method that can improve psychological symptoms in individuals with obesity that has received less attention from researchers, especially in Iran, is Group Mindfulness–Based Cognitive Therapy (GMBCT). Thus, the present study aimed to determine the effects of GMBCT on weight, body image, and self–esteem among obese individuals.

This was a quasi–experimental study with pretest–posttest–follow–up and a control group design. The statistical population of this study included all obese individuals referring to the Mehr Psychological Counseling and Psychology Center in Tehran City, Iran, in 2019. Of them, 32 subjects were selected by the convenience sampling method. Then, they were randomly divided into the groups of GMBCT and control (n=16/group). The sample size was estimated as 32 subjects based on previous studies and considering a maximum standard deviation of 10, α=0.05, and a test power of 95%. The inclusion criteria of the study were presenting obesity based on a physician's diagnosis; the age range of 30–50 years, an educational level of diploma to MA; no chronic illnesses and mental health disorders based on psychologists’ approval as well as the General Health Questionnaire (GHQ–28; Goldberg & Hillier, 1979). Absence from >2 treatment sessions and the occurrence of major stress due to unforeseen events, such as the death of a first–degree relative or divorce were also considered as the exclusion criteria of the study. The required data were collected using the Body Mass Index (BMI), the Cooper Smith Self–Esteem Inventory (Cooper Smith, 1976), and the Body Image Questionnaire (Cash & Lavallee, 1997). The mindfulness–based psychotherapy protocol was performed in eight 90–minute sessions (two sessions/week) based on Kabat–Zinn’s training package (2019). In the descriptive statistics section, mean and standard deviation were calculated. In the inferential statistics section, repeated–measures Analysis of Variance (ANOVA) and Bonferroni posthoc test were applied. Additionally, the research groups were compared concerning gender by Chi–squared test as well as age and BMI using Independent Samples t–test. The analyses were performed in SPSS at the significance level of 0.05.

The present research findings suggested that GMBCT improved BMI (weight) (group effect: p<0.001, time effect: p<0.001, time*group effect: p<0.001), body image (group effect: p<0.001, time effect: p<0.001, time*group effect: p<0.001), and self–esteem (group effect: p<0.001, time effect: p<0.001, time*group effect: p<0.001); these values were tested and followed up in the experimental group. The collected results also signified the effectiveness of GMBCT remained consistent until the follow–up phase for weight (p=0.69), body image (p=0.72), and self–esteem (p=0.81).

Based on the current research findings, GMBCT was effective on weight, body image, and self–esteem in obese individuals.