Obesity constitutes one of America's major health problems. It has been estimated that there are 40 to 80 million Americans who are considered obese (Stuart & Davis, 1972). When 20% above ideal weight is used as a criterion of overweight, it is approximated that 25% to 45% of American adults fall into this category (Rodin, 1977). There is a sex difference in the prevalence of obesity. While some studies suggest that biological factors predispose females toward obesity (Stuart & Jacobson, 1979), other studies attribute the sex differences to social factors (Hall & Havassy 1981; Wooley, Wooley, & Dyrenforth 1979a; Zegman 1983). Research has shown that females tend to be more concerned with their body image than their male counterparts and therefore dieting is more frequent among females (Dwyer & Mayer 1970; Zegman 1983). Sex differences in dietary practices and attitudes toward weight may reflect differential social learning histories between males and females.

Thesis (MA)--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: This case-based research of Mrs K, a 39 year old, white woman who has been facing weight problems since the age of six sheds light on the effectiveness of a Cognitive-behavioural hypnotherapy intervention as an aid to weight loss and the enhancement of body image and satisfaction. Literature is provided to contextualise the research question and both a quantitative and phenomenological approach to conducting the research is employed in this case study. The results are also discussed from both these perspectives. The subject’s body image improved over the eight session period and she was better able to understand and challenge her food cravings. At the start of the program she experienced thirty two cravings a week and by session eight they had reduced to 10. It was also found that the frequency of her five main self defeating cognitions (monitored and reported weekly on a cumulative basis) decreased from one hundred and twenty-one to eighty-two. While her actual weight-loss was not significant, the intervention assisted in her overall sense of well being facilitating self acceptance. The phenomenological section of this paper partially follows a model conceptualised by Fishman (2005), one of the leading founders of the journal Pragmatic Case Studies in Psychotherapy (PCSP). He advocates that as part of the study a clinical assessment and formulation be included so as to elucidate the subject’s context. It was found that Mrs K had experiences in life relating to themes of unworthiness and inadequacy. These experiences could have thus impacted on her eating behaviours resulting in negative and self defeating diet patterns to develop. / AFRIKAANSE OPSOMMING: In die enkelgevalstudie met Mev. K., ̛n 39 jarige blanke vrou wat sedert sesjarige ouderdom ̛n gewigsprobleem het, word die effektiwiteit van ̛n kognitiewe gedragshipnoterapeutiese intervensie, met betrekking tot gewigsverlies, liggaamlike selfbeeld en satisfaksie ondersoek. Kwantitatiewe sowel as ̛n kwalitatief fenomenologiese metode is gebruik om die navorsingsdata te ontleed. Tydens die agt sessies van die program het die persoon se liggaamlike selfbeeld verbeter en was daar ̛n verbeterende ingesteldheid teenoor voedsel – eetlus en kon sy dit beter verstaan en beheer. Aan die begin van die intervensie het sy 32 eetbegeertes ervaar wat afgeneem het na 10 aan die einde van die program. Die frekwensie van haar vyf hoof negatiewe gedagte-patrone (weekliks gerapporteer op ̛n kumulatiewe basis) het van 121 na 82 verminder. Terwyl haar fisiese gewigsverlies nie statisties noemenswaardig was nie, het haar oorkoepelende gevoel van algemene gesondheid haar selfaanvaarding gefasiliteer. Die fenomenologies-kwalitatiewe navorsingsgedeelte is gebaseer op die model van Fishman (2005), een van die stigterslede van die Pragmatic Case Studies in Psychotherapy (PCSP) Journal. Hy voer aan dat ‘n kliniese ondersoek en formulering in die intervensie ingesluit word om sodoende die persoon se konteks beter te skets. Die volgende temas, naamlik minderwaardigheid en ontoereikendheid, is fenomenologies geïdentifiseer. Laasgenoemde belewinge (temas) het ̛n negatiewe invloed op haar dieetpatroon gehad.

This study hypothesized body weight and eating patterns to be important discriminators of psychological characteristics among eating disordered groups. A total of 146 bulimic and non-bulimic women from underweight (anorexic), normal weight, and overweight (obese) categories were examined. Based upon the theoretical and research literature reviewed, this study hypothesized locus of control, personal potency, self-esteem, and psychopathology to be central psychological characteristics in anorexia nervosa, bulimia, and obesity. These variables were measured by Rotter's Internal-External Locus of Control Scale, the Semantic Differential Potency Scale, Rosenberg's Self-Esteem Scale, and the Minnesota Multiphasic Personality Inventory, respectively. The relative importance of these variables in the disorders was also addressed. Results showed women in the eating disordered groups examined to demonstrate the following psychological characteristics: (1) Non-bulimic anorexics--an external locus of control, low self-esteem, and hysteria; (2) Bulimic anorexics--the greatest external locus of control, the lowest self-esteem, psychopathic deviance, hysteria, thought disorder, depression, a preoccupation with somatic concerns, and hypofemininity; (3) Normal weight bulimics--an external locus of control, low self-esteem, psychopathic deviance, hysteria, thought disorder, and depression; (4) Non-bulimic obese--low self-esteem; and (5) Bulimic obese--low self-esteem, an external locus of control, thought disorder and depression. The primary conclusion drawn from this study is that bulimia is a better predictor of the psychological characteristics than body weight. Bulimia, across all weight categories, was associated with an external locus of control, low self-esteem, psychopathic deviance, hysteria, thought disorder, and depression. That there was little variability in personality characteristics associated with bulimia across weight categories emphasized the stability of the symptom constellation associated with this disorder. This study supported the view of the normal weight bulimic as psychologically similar to the bulimic anorexic. This study also supported the stance that simple obesity does not represent a unitary psychological disorder.

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A descriptive study was done to determine the difference in life satisfaction of elderly females who were overweight as compared to elderly females of ideal weight. The sample consisted of 30 females, aged 60 to 80, who were living in the community. No differences in life satisfaction scores were found between the overweight and ideal weight elderly females. The elderly females who were identified as being overweight had a mean life satisfaction score of 14.8 with a standard deviation of 2.45. Elderly females of ideal weight had a mean life satisfaction score of 15.9 with a standard deviation of 2.12. Major differences in summated results of selected demographic variables were not found for the elderly females who were overweight as compared to the elderly females of ideal weight. Findings from the study and implications for nursing are discussed. Recommendations for further research are included.

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This thesis examined the effects of weight and dietary restraint on eating at times of emotional distress. The emotional reactivity of subjects differing in weight and restraint was also examined. Forty female and 40 male subjects were classified as high, moderate, or low on Body Mass Index (BMI), and as high, moderate, or low on each of the factors of the Three-Factor Eating Questionnaire (TFEQ; Stunkard & Messick, 1985). Mood was manipulated by exposing all subjects to a challenging cognitive task, which had been made insoluble for half the subjects. All subjects were then asked to taste and rate a variety of cookies. Mood was evaluated using self-report measures and by monitoring changes in heart rate, blood pressure, and skin conductance. Distressed male subjects with high scores on two TFEQ subscales were found to eat significantly more than their non-distressed counterparts. Female subjects with high scores on the third TFEQ subscale were shown to eat less when distressed. Weight was found not to have a significant effect on the amount consumed by male or female subjects. There was some evidence to suggest that females with high scores on two TFEQ subscales are more emotionally reactive than those scoring lower. The evidence for increased reactivity in restrained males was weaker. There were no differences in reactivity as a function of BMI. Differences in emotional reactivity could not account for observed differences in eating among groups varying in restraint. The results suggest that, as has been found for female subjects in other studies, restrained males are also susceptible to the breakdown of control that leads to overeating in the face of distress. They should be included in future examinations of restraint.

There is no abstract available for this dissertation.

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