Introduction: Obesity is one of the greatest public health challenges world wide and its prevalence has increased during the past 20-30 years. Obesity is related to physical and mental health and increased mortality. There are few evidence-based treatment options for the obese available in Iceland.

Material and methods: The purpose of this pilot study was to develop a 15 week group program based on Cognitive Behavior Therapy and Appetite Awareness Training for young obese women. The participants were randomly allocated to two groups, A and B, in a convenience sample of 20 women, aged 19-44 with a BMI 30-39.9 kg/m². Group A attended the program while group B served as a control in a crossover design where group B subsequently participated in the program. The effectiveness of the program was evaluated before, during and at the end of the program and at six and twelve month follow-up. Information was collected on body weight, BMI, body fat and body fat mass, blood pressure, cholesterol, triglyceride, high density lipoprotein and 25(OH)D, quality of life (SF-36  and OP scale), symptoms of depression (BDI-II) and anxiety (BAI). Additionally participants completed a questionnaire on demographics and their view on participating in the program was assessed.

Results: Participants reduced their weight (P=0.001), BMI (P=0.001), body fat (P=0.010), body fat mass (P=0.002), diastolic blood pressure (P=0.005) and vitamin D status improved (P=0.008). Symptoms of depression and anxiety decreased (P<0.001 and P<0.004). Quality of life measured with OP scale improved (P=0.006) and the mental component summary (MCS) (P=0.012) of the SF-36 scale. The mean weight loss was 3.7 kg following intervention which was maintained at follow up.

Conclusion: „The enjoy eating“ program is a promising health promotion approach in the health care sector for obese women to improve mental health, quality of life and loose weight.

Key words: Obesity, cognitive behavior therapy, appetite awareness training, program, mood.

Tables and figures:

Table II. Results before and after intervention,  P-value  in group A + B, group A and group B

Table III. Group A+B. Results before and after intervention an at six and twelve-month follow-up.

Figure  1. Intervention period  (15 weeks) and followup (12 months).

Figure 2. Structure of sessions in the „Enjoy Eating“program.

Figure 3. Depressive symptoms (BDI-II) in group A measured at monthly intervals from the beginning to the end of the program.

Figure 4. Depressive symptoms (BDI-II) in group B; the first two boxes show symptoms while the group served as a control group and the following ones the development during the program period.

Correspondence: Eiríkur Örn Arnarson, eirikur@lsh.is

Larusdottir H, Saevarsdottir H, Steingrimsdottir L, Gudmundsson L, Arnarson EO

¹University of Iceland ²Landspitali University Hospital ³Primary Health Care of the Capital Area ⁴ Unit for Nutrition Research ⁵Reykjalundur Rehabilitation Centre