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Higher Self-Esteem Linked to Better Weight Loss in Group Therapy
Developing
In Short: Researchers found that participants with higher self-esteem scores experienced better weight loss outcomes in group therapy settings compared to individual therapy.
The study, a secondary analysis of an earlier clinical trial, involved 1220 participants at 36 rural primary care clinics in the Midwest.
In-clinic group visits were found to be more effective than in-clinic individual visits, although the differences were small.
Christie Befort, PhD, a professor at the University of Kansas Medical Center, explained that group therapy provides additional support and accountability among peers.
Byron Gajewski, PhD, another co-author of the study, noted that patients with higher self-esteem scores showed a 15-pound weight loss improvement in group settings.
However, the effectiveness of group therapy diminished as self-esteem scores dropped below 60.
Lindsay Fourman, MD, from Massachusetts General Hospital, advised interpreting the findings with caution, as they do not establish causality.
Gajewski suggested that clinicians could use self-esteem scores to predict weight loss outcomes and set more accurate expectations for patients.
He also noted that while some patients may initially hesitate, they can quickly adjust to group settings.
The study highlights the importance of considering individual psychological factors when choosing between group and individual therapy for weight loss.
What this adds
The study adds to the ongoing debate about whether individual or group therapy is more effective for weight loss.
It also underscores the need for clinicians to be mindful of patients' psychological readiness for group therapy.
Background
Eli Lilly's new GLP-1 drug retatrutide helped people with Type 2 diabetes lose up to 60 pounds, or about 23% of their body weight, according to late-stage trial results published Tuesday in The Lancet.
What's still developing
- Now, researchers have found that people less bothered by weight stigma, as assessed by higher-than-average self-esteem scores, may do better with group therapy.
- “Lifestyle interventions delivered in a group format provide additional accountability, support, modeling, and helpful information among peers, all of whom are striving to make similar changes in their nutrition and physical activity habits,” Christie Befort, PhD, professor of population health at the University of Kansas Medical Center and a researcher on both studies, told Medscape Medical News in an email interview.
- “In general, family medicine colleagues I have spoken to understand that group visits may be more powerful for producing weight loss than individual visits,” he said in an email interview.
- They also feel it makes sense that patients might need to have a certain level of self-esteem in order to successfully engage in group visits, he said.
- He suggests clinicians be aware of some patients’ vulnerability in group settings, at least initially, but he recalls a patient he referred to a group program who adjusted quickly after the initial hesitation.
- If a patient is interested, he said, a clinician might predict weight loss based on the score.
- “While the finding is important for future research,” it “should be interpreted with caution,” said Lindsay Fourman, MD, associate director of Lipid and Metabolism at the Massachusetts General Hospital in Boston, as association does not mean causality.
- Behavioral interventions that focus on diet, physical activity, and behavioral change have long helped people with obesity lose weight.
- An ongoing question, however, is whether an individual or a group therapy approach works better.
- For the new study, the researchers decided to dig further into the information already collected in the earlier study to determine if the degree of stigma a patient feels about excess weight might be a factor in one approach working better than another.
- The researchers wanted to know: Do those who feel less stigmatized about weight do better in group settings?