The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) on Sexual Self-Esteem in Obese Women

   CURRENT RESEARCH IN DIABETES & OBESITY JOURNAL JUNIPER PUBLISHERS

Authored by Mohammad Soltanizadeh

Abstract

This study aimed to evaluate the effectiveness of mindfulness-based cognitive therapy on sexual self-esteem in obese women. The design of the present study was a quasi-experimental design with pre-test, post-test, and 6-months follow-up and control group. Using the convenience sampling method, 30 obese women were selected and randomly assigned to experimental and control groups. The experimental group received 8 sessions of mindfulness-based cognitive therapy intervention. The female sexual self-esteem scale in the pre-test, post-test, and follow-up stages was performed for both groups and the findings were analyzed using two-way repeated measures ANOVA. The results showed that there was a significant difference between the experimental and control groups in the component of sexual self-esteem in the post-test and follow-up stages (P<0.05). Based on these findings, it can be concluded that mindfulness-based cognitive therapy training improves sexual self-esteem in obese women.

Keywords: Mindfulness-based cognitive therapy; Sexual self-esteem; Obesity

Introduction

The prevalence of overweight and obesity has steadily increased in recent decades and has been raised as a global health problem [1]. Obesity is a disease characterized by the accumulation of fat in the body and leads to greater susceptibility to cardiovascular disease, hypertension, type 2 diabetes, respiratory problems, fatty liver, depression and some types of cancer. In addition to psychosocial effects and impact on quality of life, these diseases reduce life expectancy and premature death [2]. In this context, the definition of obesity as a disease will have a strong impact on both the individual (stigma, self-esteem) and society (attention of health care professionals or politicians) [3]. Studies have shown that obese people have low self-esteem, and their self-esteem decreases with increasing body mass index (BMI) [4].

Therefore, the concept of sexual self-esteem is also explained based on general models of self-esteem and is described as a positive assessment of one’s sexuality, including the assessment of sexual thoughts, feelings and behaviors, as well as the perception of one’s body in a sexual context [5]. When sexual self-esteem is severely impaired, it causes a kind of disability that significantly impairs a person’s functioning. In recent years, developments in the treatment of psychological disorders and reduction of obesity have led to the introduction of new treatment methods by clinical psychologists [6,7]. One of these therapies is mindfulness-based cognitive therapy, which is a sustainable and effective treatment in case of people’s lifestyles and empowers a person to deal with everyday problems without the need for medication [8]. In this method, meditation exercises are used to create mindful awareness so that the person accepts unpleasant feelings and thoughts and realizes the mutual and reciprocal effect of feelings and thoughts on the body [9].

According to the evidence for the effectiveness of mindfulness-based cognitive therapy on several disorders such as rumination, depression, anxiety sensitivity, eating disorders and also due to lack of applied research on the effectiveness of this treatment on obesity and the resulting factors, this research aimed to investigate the effectiveness of mindfulness-based cognitive therapy on sexual self-esteem in obese women.

Method

The design of the present study was a quasi-experimental design with pre-test, post-test and 6-months follow-up and control group. The statistical population was all women with obesity in Isfahan, Iran. Using an advertisement on the internet and social media, 60 women with obesity were selected based on inclusion and exclusion criteria and randomly assigned to experimental and control groups. Inclusion criteria were having a body mass index above (BMI) 30, being married, not participating in another course of psychological intervention and age less than 50 years. Exclusion criteria were unwillingness to participate in intervention sessions and having severe marital conflicts.

To measure sexual self-esteem, the sexual self-esteem questionnaire of Zeanah & Schwarz [10] was used. This questionnaire has 35 questions with a five-point range from strongly disagree to strongly agree. Higher scores indicate higher sexual self-esteem. Cronbach’s alpha coefficient for the whole scale was estimated 0.92 [10]. In the present study, Cronbach’s alpha coefficient for the whole scale was 0.88. To perform the intervention, the experimental group received mindfulnessbased cognitive therapy in 8 sessions (Table 1). Data analysis was performed using two-way repeated measures ANOVA and SPSS- 23 software.

Results

The mean age of participants in the experimental and control groups was 36.25 and 37.30 years old, respectively. Participants’ education varied from elementary to undergraduate and diplomas were the most frequent. Table 2 presents the descriptive indicators obtained for the sexual self-esteem variable.

The normality, the homogeneity of the error variances and the sphericity assumption of two-way repeated measures ANOVA was evaluated and confirmed.

The results showed that there is a significant difference between the sexual self-esteem of the experimental and control groups. There is also a significant difference between the scores of sexual self-esteems in the three stages of the test. The interaction of intervention and time is also significant (P<0.01).

Discussion

This study aimed to evaluate the effectiveness of mindfulnessbased cognitive therapy on sexual self-esteem in obese women. The results showed that mindfulness-based cognitive therapy was effective on sexual self-esteem in obese women. In other words, a significant difference was observed in the level of sexual selfesteem of the experimental group compared to the control group in the pre-test, post-test and follow-up. This finding is consistent with the findings of Hannier & Asadpour et al. [13]. Sexual selfesteem refers to a person’s beliefs about the degree of sexual attractiveness, the ability to enjoy and enjoy a sexual relationship, and the ability to satisfy one’s spouse. When sexual self-esteem is impaired, a person’s self-esteem, life satisfaction, capacity to experience pleasure, eagerness to interact with others, and the ability to form intimate relationships are limited. Mindfulness-based cognitive therapy affects the cognitive system and information processing by increasing people’s awareness of the present, through techniques such as mindful breathing, body scan and turning awareness to the here and now, reducing negative thoughts and feelings related to gender roles. In mindfulness skills, the attention shifts from disturbing thoughts to activities that are done in the present moment, such as mindful breathing, mindful walking or awareness of sounds. As a result, it reduces self-critical thoughts and shapes and strengthens positive beliefs and evaluations about oneself and increases sexual self-esteem in obese women.

One of the limitations of this study was the concurrence of psychological intervention with nutrition counselling services, which may affect the overall performance of the sample by reducing the weight of the sample. According to the findings of this study, the use of mindfulness-based cognitive therapy on sexual self-esteem, considering marital problems and conflicts, is suggested as a moderating variable.

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