Abstract
Background & AimsThe long-term success of life-style interventions in the treatment of obesity is limited. Although psychological factors have been suggested to modify therapeutic effects, specifically the implications of attachment styles and the patient-therapist relationship have not been examined in detail yet.MethodsThis study included 44 obese patients who participated in a one-year multimodal weight-reduction program. Attachment style was analyzed by the Adult Attachment Prototype Rating (AAPR) inventory and its relation to a one-year weight reduction program was studied. The patient-therapist-relationship was assessed using the Helping Alliance Questionnaire.ResultsAttachment style was secure in 68% of participants and insecure (preoccupied and dismissing) in 32%. Interestingly a significantly higher weight-reduction was found in securely (SAI) compared to insecurely attached individuals (UAI; p < 0.05). This estimation correlated positively also to the quality of helping alliance (p = 0.004).ConclusionsThe frequency of insecure attachment in obese individuals was comparable to that of the normal population. Our data suggest a greater weight-reduction for SAI than for UAI, and the patient-therapist relationship was rated more positively. The conclusion can be drawn that a patient's attachment style plays a role in an interdisciplinary treatment program for obesity and has an influence on the effort to lose weight.
Highlights
The incidence of obesity is increasing worldwide
We assumed that obese patients, like patients with other eating disorders [18,19] may have a more insecure attachment style compared to clinically normal subjects
Secure and insecure patients did not differ with respect to sex, age, or Body mass Index (BMI), but did differ in regard to weight in kg at baseline (0.034, Table 1)
Summary
The incidence of obesity is increasing worldwide. Data from the German microcensus conducted in 2005 revealed that about 58% of adult men and 42% of adult women are overweight (Body Mass Index ≥ 25 kg/m2) [1].This is of special importance given that obesity is one of the major risk factors for diabetes, cardiovascular disorders and cancer [2,3,4]. large intervention trials were able to demonstrate that a multimodal life-style intervention can prevent type 2 diabetes mellitus in individuals at risk, the long-term effect of those interventions on body weight is limited [5,6]. Data from the German microcensus conducted in 2005 revealed that about 58% of adult men and 42% of adult women are overweight (Body Mass Index ≥ 25 kg/m2) [1] This is of special importance given that obesity is one of the major risk factors for diabetes, cardiovascular disorders and cancer [2,3,4]. The poor long-term success of weight reduction may be based on the fact that obesity is a Attachment theory assumes that humans and most mammals have a biologically predisposed attachment system [13]. This system is responsible for the strong emotional mother-child (primary caregiver-child) relationship [14]. Psychological factors have been suggested to modify therapeutic effects, the implications of attachment styles and the patient-therapist relationship have not been examined in detail yet
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