According to the Centers for Disease Control and Prevention, almost 40 percent of adults and 18.5 percent of children in the United States are obese. This number is alarming, when you consider the severe health consequences of being overweight. These include heart disease, stroke and diabetes.
Due to the health implications, it is not a surprise that a whole industry has emerged to promote weight loss. Interventions may include specialized diets, psychotherapy, medication, and even bariatric surgery. Many treatments claim success, but no one remedy has surfaced as a cure-all for being overweight. It appears that losing weight is a highly individualized process and one needs to find the particular treatment that works best for them.
For the past half-century, hypnosis has received considerable interest as a weight loss treatment. In this article, I will explore the facts behind using hypnosis recordings and having hypnotherapy sessions as a weight reduction method and the evidence that supports their effectiveness.
How Does Hypnosis Work for Weight Loss?
If hypnosis is a viable treatment for weight loss, we first must determine the underpinnings for its success. The following factors have received attention as to why hypnotherapy is an effective weight loss solution:
Research has identified a link between self-esteem and obesity. Ternouth, Collier & Maughan  found that low self-esteem in childhood predicted obesity as an adult. French, Story, and Perry  reviewed 35 studies that explored the link between self-esteem and obesity in children and adolescents. Thirteen of those studies showed lower self-esteem was associated with obesity, although one may question causality, due to it being a cross-sectional analysis. Since cross-sectional analyses measure data at one point, in this case, they can only show that an association exists between self-esteem and obesity, not that one causes the other.
The use of ego enhancement or ego-strengthening is a technique frequently referred to in the hypnosis literature. Although the exact suggestions that are used to promote ego-enhancement are not always clear, Stafrace states: “ego-strengthening comprises a set of standard suggestions aimed at augmenting the client’s ego, ego defenses, and general sense of self-worth, with the expectation that such an outcome will facilitate symptom resolution”. Further, he found four studies that supported the contention that hypnosis aids in self-esteem. In a study of obese women, Gelo, Zips, Ponocny-Seliger, Neumann, Balugani & Gold  utilized multiple hypnotic suggestions aimed at increasing self and body-image. For example, one suggestion said, “Because all this, it’s ok, and you are ok, and your body can just do nothing but reflect the good flow inside and outside yourself”.They found that groups that utilized hypnotherapy reduced weight and improved body concept. Levitt  notes that ego-enhancing suggestions are often given as part of a hypnosis protocol aimed at increasing weight loss. Practically speaking, suggestions aimed to boost self-esteem can do little harm and may provide positive health benefits.
Anxious feelings and obesity appear to be related. Gariepy, Nitka & Schmitz  found “a moderate level” of evidence associating obesity and anxiety. Moreover, Ternouth et al.  found that worrying in childhood was predictive of adult obesity.
Hypnosis and Anxiety
Hypnosis has often been touted as an effective treatment for anxiety among the general public. Because hypnosis is so often associated with relaxation and calm, it is thought to be an ideal antidote for worry. In fact, approximately 25 percent of all hypnosis apps target relaxation and phobias.  Scientific research also supports that contention. Golden (2012)-9 found that cognitive hypnotherapy was at least as effective as behavioral therapy and cognitive-behavioral therapy alone in the treatment of anxiety disorders. Further, Fredette, El-Baalbaki, Neron & Palardy  endorse the use of hypnosis in the treatment of social phobia, panic disorder, and generalized anxiety. Hammond  concludes that hypnosis has been successful in treating anxiety-related disorders, such as irritable bowel syndrome, test anxiety, and headaches. There is also evidence of bruxism hypnosis being effective in treating the underlying anxiety that leads to teeth grinding.
Stress has also been cited as related to weight gain. It is not uncommon to hear people talk anecdotally about stress eating. Stress eating is also supported by science. Chronic stress releases a chemical called cortisol, which increases appetite. In addition, stress promotes an “anabolic state that promotes fat storage within visceral depots, which increases the risk of dyslipidemia, type 2 diabetes, cardiovascular disease, and other facets of the metabolic syndrome.”  Further, stress appears to be linked to poor food choices, including food that is high in fat and sugar. These types of foods appear to reduce stress, reinforcing the desire for junk food during stressful moments. Unfortunately, stressful times are the norm for many. A quarter of Americans rate their stress level an eight or more on a ten-point scale.
Hypnosis as a Stress Reducer
At face value, hypnosis has validity as a stress reducer. It is seen as a calming process and induction procedures often utilize relaxation exercises to produce a hypnotic state. Indeed, Sucula et al.  reported that almost 20 percent of hypnosis apps are used to reduce stress. Fisch, Brinkhaus & Teut  concluded that a majority of studies they reviewed reported a reduction in perceived stress when using hypnosis compared to control groups. Further, Straddling, Roberts, Wilson & Lovelock  found that hypnosis that focused on stress reduction was effective in weight loss, even more so than direct suggestions of weight loss behavior.
One of the main challenges with any of any weight-loss regimen is the individual’s motivation to stick with the program. For example, you may know that you need to exercise regularly, but you may also lack the motivation to do it. Through the power of suggestion, hypnosis aims to help maintain motivation to follow through with positive weight-loss behaviors. Carmody, Duncan, Simon, Solkowitz, Huggins, Lee & Delucchi  used hypnosis to motivate participants in complying with smoking cessation. Although losing weight and stopping smoking are not the same, they are behaviors that have proven resistant to change and show the potential efficacy of hypnosis in helping to foster motivation. Obtaining and maintaining a commitment to losing weight is the primary goal of any weight-loss regimen.
Giving individuals direct suggestions while under trance has historically been a primary component of hypnosis protocols for weight loss. For example, while under a hypnotic trance, a hypnotherapist will instruct a client to follow a particular diet and exercise plan and engage in healthy eating habits. Vanderlinden & Vandereycken  note that suggestions can be quite specific, such as instructing people to eat at certain times and places as well as restricting clients from buying specific foods. Direct suggestions can circumvent motivation problems by increasing the commitment to certain weight-loss behaviors.
Weight-loss suggestions are not always positively motivating. At times, they can be aversive, relaying that certain behavior is going to lead to negative consequences. For instance, in an experiment examining the effect of hypnosis on weight loss in obese individuals, participants were given the suggestion “for my body, overeating is poison.” The experimenters followed that up with aversive suggestions tailored for the subjects’ particular eating habits. For example, instead of just “overeating is poison”, a person would receive the suggestion “for my body, potato chips are poison”. Interestingly, stronger effects were found when aversive messages were specific to foods that the participants ate often as compared to more general aversive suggestions. In addition, Levitt  notes that classical conditioning has been used with mixed success in aversive hypnosis research for weight loss. He reports that the ingestion of foods has been paired with unpleasant physical sensations, such as feelings of “nausea and repugnant tastes”.
Another aspect of hypnotherapy that aids in motivation—as well as self-esteem—is the use of imagery. Levitt  notes that end-result imagery, where someone pictures themselves after weight loss, appears to be effective. Picturing yourself as successful inspires confidence and motivates one to maintain weight loss behavior. Further, weight loss imagery overlaps with enhancing self-esteem, since it causes you to feel good about a successful outcome.
Is Your Unconscious Mind Working Against You?
The unconscious is an aspect of the human condition that may play a role in decreasing motivation to lose weight. Entwistle, Webb, Abayomi, Johnson, Sparkes & Davies  hypothesize that unconscious controls maintain weight by inhibiting diet and exercise planning. They believe that weight maintenance is an unconscious defense against certain types of past trauma and therefore prevents weight-loss behavior. As a result, they conclude that hypnosis—which is posited to access the unconscious—will be able to break down these defenses when other interventions fail.
Does Hypnosis Work for Weight Loss?
The primary question that must be answered concerning hypnosis as a treatment for weight loss is:
Does it work? Unlike some other areas of hypnotherapy, there is considerable research that has attempted to provide the answer. Milling et al.  performed a meta-analysis of research measuring the impact hypnosis on weight loss. They found a significant effect of hypnosis on weight loss, concluding the average person lost almost seven pounds over six weeks. In addition, Cochrane and Friesen  found that group and individual hypnotherapy did lead to significant weight loss when compared to a control group. Straddling et al. (1998)-15 also found that hypnotherapy resulted in a statistically significant weight loss when compared to baseline. However, not all research conclusions are as enthusiastic. Allison, Fontaine, Heshka, Mentore & Heymsfield, in an exploration of relevant research, found only “modest” effects, if any, when examining the effect of hypnosis on weight loss.
Hypnosis as an Adjunct Treatment
It would be remiss to consider the effectiveness of hypnosis on weight loss without reviewing the use of hypnosis as an adjunct treatment. Although research has examined hypnosis as a lone intervention, many studies consider hypnosis as part of a treatment protocol. Most often, this takes the form of adding hypnosis to a cognitive-behavioral therapy (CBT) intervention or as an addition to a simple educational/behavioral component. For example, Byom and Sapp  found that people who received a combination of hypnosis with CBT lost significantly more weight when compared to a group that only received education in nutrition and exercise.
In a review of research literature, Kirsch, found that hypnosis significantly enhanced weight loss when used in conjunction with CBT. Allison, Faith & Myles, in contrast, found that hypnosis adds very little to what only CBT provides. Schoenberger  gave a mixed review, stating that while the evidence is promising, it is plagued by “methodological limitations”.
In a more recent analysis, Milling et al.,  found that hypnosis is most beneficial when used in conjunction with CBT. In fact, they concluded that hypnosis was significantly more effective when utilized together with CBT than when either is used as a stand-alone intervention.
The Use of Self-hypnosis for Weight Loss
When research studies discuss using hypnosis as an intervention for weight loss, they are frequently talking about self-hypnosis. Self-hypnosis can be defined as participants performing hypnosis on themselves, usually after a period of practice with trained professionals. At times, they will be guided by a previously recorded audio.
It is thought that self-hypnosis is a more practical intervention, because most people do not have a hypnotherapist available during regular daily activities. Milling et al.  found that using self-hypnosis substantially increased the effectiveness of hypnotic interventions for weight loss. They proposed that it would be especially useful when dealing with chronic conditions, such as obesity, that require the use of hypnosis over a long period of time. Not everyone has found self-hypnosis as successful, however. Bo, Rahimi, Goitre, Properzi, Ponzo, Regaldo, Boschetti, Fadda, Ciccone, Abbate Daga, Mengozzi, Evangelista, De Francesco, Belcastro & Broglio  instituted a self-hypnosis protocol to be administered before meals, but did not find that it had a significant effect on weight loss. It was associated, however, with measures of increased satiety (people feeling more full and therefore eating less), improved quality of life, and decreased inflammation.
The Pros and Cons of Self-Hypnosis
The great advantage of self-hypnosis is being able to use it whenever it is needed, after a person is initially trained in how to do it. This may alleviate the need to visit a hypnotherapist as frequently. Used correctly, it can be a highly-powerful tool.
The primary weakness of self-hypnosis is not knowing exactly how an individual is employing it. Levitt  notes that research does not always specify how self-hypnosis is used, but does assume you are using it as instructed by a professional. The truth is that no one can be sure that people are using self-hypnosis correctly. For example, it is possible that someone using self-hypnosis is not actually achieving a hypnotic state, but is rather simply feeling relaxed. Therefore, the lack of reliability makes it difficult to ascertain the effectiveness of self-hypnosis interventions.
Does Hypnosis Reduce Weight Long-Term?
One of the primary challenges with weight loss is that people often gain back the weight. Milling et al.  note that individuals participating in a weight-loss intervention usually gain back half the weight they lost after a year and almost all of it within five years. Any treatment that could produce better results would be considered invaluable. Fortunately, hypnosis research brings some reason for promise. Cochrane and Friesen  found that participants receiving hypnotherapy lost significantly more weight at a six-month follow-up than they had in one month. Stradling et al.  reported that hypnosis that focused on stress reduction led to a small but significant weight loss after 18 months. Bolocofsky, Spinler & Coulthard‐Morris  performed a study in which the long-term effects of hypnosis on weight reduction were compared with a behavioral intervention. They found that only hypnosis led to an increase in weight loss at eight-month and two-year follow-up. In fact, individuals did not just maintain their weight loss; They actually lost more weight at the two-year mark than they had previously.
While this research points to the possibility that hypnosis can lead to continued long-term weight loss, there are only a few hypnosis studies that measure long-term outcomes. What’s more, these studies are over 20 years old. So, while hypnosis may hold promise as a long-term answer to weight loss, there is presently not enough research to support that presumption.
Does Hypnotizability Matter?
Hypnotizability, often called hypnotic suggestibility, is a measure of how easily one can be hypnotized. Taken at face value, it would seem reasonable to assume that the more hypnotizable you are the more hypnotic interventions would lead to weight loss. This, of course, would be valuable information to have in measuring the efficacy of any hypnotic treatment. Unfortunately, the value of measuring hypnotizability is not so cut and dry. In a study analyzing the role of hypnotizability in clinical treatment, Montgomery, Schnur, & David  found that there was a small but significant association between hypnotizability and success from hypnotic treatment. However, they found that only six percent of the variance in treatment outcomes was due to hypnotic suggestibility, meaning that hypnotizability did not account for much of the success.
Hypnotizability and Weight Loss Treatment
When we look specifically at the area of weight loss, the importance of hypnotic suggestibility receives similarly mixed results. Barabasz and Spiegel  found a positive correlation between hypnotic suggestibility and weight loss. Additionally, they note there is evidence that clients with bulimia are more hypnotizable than those with anorexia, which they speculate may make hypnosis especially effective with the bulimic population. Entwistle et al.  also found a significant correlation between hypnotizability and weight loss.
On the other hand, Cochrane and Friesen  and Bo et al.  found that suggestibility to hypnosis did not correlate with any weight loss measure.
As might be surmised from the research, Levitt  concludes that the value of hypnotizability in weight loss is inconclusive. We may infer that due to the time, money, and effort it takes to administer hypnotic suggestibility evaluations, the cost of finding out whether someone is hypnotizable may not be worth the benefit.
Considerations for Hypnosis as a Weight Loss Treatment
Research has generally found positive effects when using hypnosis for losing weight, but it has also revealed the following issues:
Statistical vs. Clinical Significance
Although the subjects in weight loss studies usually lose some weight, the reductions from hypnotic procedures do not always reach experimental significance.  So, while participants may lose weight, it is not much beyond baseline levels. Further, even when people lose a statistically significant amount of weight, it may not be clinically valuable. For example, while someone may lose seven pounds over six weeks, that is not very much for an individual who is obese and needs to lose 50 or more pounds.
Studies Lack Robust Psychometric Properties
Many of the hypnosis studies lack robust psychometric properties.  Unfortunately, this is not a challenge specific to the hypnosis weight loss literature. Much of hypnosis research lacks adequate levels of reliability and validity. The field is plagued by a lack of randomized control trials that do not hold up to scientific scrutiny.
Research on hypnotic treatments for weight loss was popular in the 20th century. Since the turn of the century, there are only a handful of competent original studies that are not reviews of past research. Part of the issue is that hypnosis does not get as much respect as some other interventions. That is often why you see it used as an adjunct to CBT and other treatments. Current research using randomized controlled trials is needed to support the validity of hypnosis as a treatment for weight loss.
The Promise of Hypnosis as a Weight Loss Treatment
Having noted some of the challenging issues, it needs to be said that the hypnotic weight loss literature is some of the most promising in the field of hypnosis. There are multiple studies with good psychometric properties that point to its effectiveness, especially when used in conjunction with CBT. Particularly positive is the potential for hypnosis as an effective treatment for the maintenance of long-term weight loss. The ability to lose weight and keep it off has positive implications for many health conditions, including obesity, eating disorders, and diabetes.
What’s more, the public appears to believe in the potential of hypnosis as a weight loss treatment. Almost 23 percent of hypnosis apps are related to weight loss, the most of any category. Whatever questions remain about the research, it appears that a lot of people are turning to hypnosis to lose weight. They may be on to something.
P.S. Here is a free hypnosis session for weight loss. It not contain music or binaural tones (my enhanced weight loss hypnosis mp3 does).
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