.: ORİJİNAL ARAŞTIRMA
Hipnoterapinin Obezite Hastalarında Kilo Kaybıyla Beraber İnsülin Direncine Olan Etkisi
Effects of Hypnotherapy on Weight Loss and Thus on Insulin Resistance in Obese Patients
J Tradit Complem Med. 2020;3(3):367-74
doi: 10.5336/jtracom.2020-75823
Makale Dili: TR
Tam Metin
ÖZET
Bu çalışmada, sağlıklı ve dengeli beslenmeyi sağlamak amacıyla hipnoterapi seansına başvuran obezite hastalarında uygulanan hipnoterapinin, seans sonucunda kilo kaybıyla beraber insülin direncine olan etkisininin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, beden kitle indeksleri (BKİ) 30 kg/m2 ve üstü olan, 10 haftalık seansı tamamlayan toplam 41 birey alındı. Haftada 1 seans olmak üzere 2,5 ay boyunca hipnoterapi seansı uygulandı. Hipnoterapi seansının başlangıcında ve sonunda BKİ, açlık kan şekeri (AKŞ) ve açlık serum insülin düzeyleri ölçüldü. İnsülin direnci, HOMA-IR testi ile belirlendi. Bulgular: Hastaların, ortalama BKİ değerleri, seans başlangıcında 33,60±4,92 kg/m2 iken seans bitiminde 31,41±4,65 kg/m2 olarak belirlendi. Serum insülin düzeyleri, seans başlangıcında 15,89±8,19 μIU/mL, seans bitiminde 12,15±7,05 μIU/mL olarak tespit edildi. İnsülin direnci ise seans başlangıcında 3,81±2,27, seans bitiminde 2,92±1,96 olarak tespit edildi. Buna göre hipnoterapi seansı sonrası BKİ, serum insülin düzeyleri ve insülin direnci anlamlı ölçüde azalmıştır. Ayrıca AKŞ, insülin düzeyleri ve insülin dirençlerinin birbirleri arasında, pozitif yönde istatistiksel olarak anlamlı bir korelasyon saptandı. Sonuç: Bu araştırma, obezite tedavisinde hipnoterapinin, obezite hastalarında kilo kaybına ve bunun sonucunda insülin direncinde dikkate değer oranlarda değişiklilere neden olduğunu işaret etmektedir. Hipnoterapinin; kolay uygulanması, etkili olması, yan etkisinin olmaması, ayrıca gerek tek başına gerekse diğer tedavilere eklenerek uygulanması obezite tedevisinde bazı avantajlar sağlayabilir
Anahtar Kelimeler: Obezite; hipnoterapi; kilo kaybı; insülin direnci
Bu çalışmada, sağlıklı ve dengeli beslenmeyi sağlamak amacıyla hipnoterapi seansına başvuran obezite hastalarında uygulanan hipnoterapinin, seans sonucunda kilo kaybıyla beraber insülin direncine olan etkisininin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, beden kitle indeksleri (BKİ) 30 kg/m2 ve üstü olan, 10 haftalık seansı tamamlayan toplam 41 birey alındı. Haftada 1 seans olmak üzere 2,5 ay boyunca hipnoterapi seansı uygulandı. Hipnoterapi seansının başlangıcında ve sonunda BKİ, açlık kan şekeri (AKŞ) ve açlık serum insülin düzeyleri ölçüldü. İnsülin direnci, HOMA-IR testi ile belirlendi. Bulgular: Hastaların, ortalama BKİ değerleri, seans başlangıcında 33,60±4,92 kg/m2 iken seans bitiminde 31,41±4,65 kg/m2 olarak belirlendi. Serum insülin düzeyleri, seans başlangıcında 15,89±8,19 μIU/mL, seans bitiminde 12,15±7,05 μIU/mL olarak tespit edildi. İnsülin direnci ise seans başlangıcında 3,81±2,27, seans bitiminde 2,92±1,96 olarak tespit edildi. Buna göre hipnoterapi seansı sonrası BKİ, serum insülin düzeyleri ve insülin direnci anlamlı ölçüde azalmıştır. Ayrıca AKŞ, insülin düzeyleri ve insülin dirençlerinin birbirleri arasında, pozitif yönde istatistiksel olarak anlamlı bir korelasyon saptandı. Sonuç: Bu araştırma, obezite tedavisinde hipnoterapinin, obezite hastalarında kilo kaybına ve bunun sonucunda insülin direncinde dikkate değer oranlarda değişiklilere neden olduğunu işaret etmektedir. Hipnoterapinin; kolay uygulanması, etkili olması, yan etkisinin olmaması, ayrıca gerek tek başına gerekse diğer tedavilere eklenerek uygulanması obezite tedevisinde bazı avantajlar sağlayabilir
Anahtar Kelimeler: Obezite; hipnoterapi; kilo kaybı; insülin direnci
ABSTRACT
Objective: In this study, it was aimed to investigate effects of hypnotherapy on weight loss, and thus on insulin resistance in obese patients who presented to the psychiatry outpatient clinic to participate in hypnotherapy sessions to develop healthy and balanced diet. Material and Methods: The study sample included 41 individuals with a body mass ındex (BMI) of ≥30 kg/m2 who completed the 10-week hypnotherapy. Hypnotherapy session was performed for 2.5 months, one session per week. BMI, fasting blood glukoz (FBG) and fasting serum insulin levels were measured at the beginning and end of the hypnotherapy session. Insulin resistance was determined by HOMA-IR test. Results: The mean BMI values of the patients were 33.60±4.92 kg/m2 and 31.41±4.65 kg/m2 at the beginning and end of the hypnotherapy sessions respectively. Serum insulin levels were 15,89±8,19 μIU/mL at the beginning of the hypnotherapy sessions were 12.15±7.05 μIU/mL at the end of the hypnotherapy sessions. Insulin resistance were 3,81±2,27 at the beginning of the hypnotherapy sessions were 2.92±1.96 at the end of the hypnotherapy sessions. The results showed that BMI, serum insulin levels and insulin resistance decreased significantly after the hypnotherapy sessions. In addition, there were statistically significant correlation between the beginning and end of the hypnotherapy sessions FBG, serum insulin levels and insulin resistance. Conclusion: This study indicates that hypnotherapy in obesity treatment leads to weight loss in obese patients and thus to considerable changes in insulin resistance. Hypnotherapy is easy to apply, effective, has no for side effects, and can be applied both alone and in combination with other treatments.
Keywords: Obesity; hypnotherapi; weight loss; insulin resistance
Objective: In this study, it was aimed to investigate effects of hypnotherapy on weight loss, and thus on insulin resistance in obese patients who presented to the psychiatry outpatient clinic to participate in hypnotherapy sessions to develop healthy and balanced diet. Material and Methods: The study sample included 41 individuals with a body mass ındex (BMI) of ≥30 kg/m2 who completed the 10-week hypnotherapy. Hypnotherapy session was performed for 2.5 months, one session per week. BMI, fasting blood glukoz (FBG) and fasting serum insulin levels were measured at the beginning and end of the hypnotherapy session. Insulin resistance was determined by HOMA-IR test. Results: The mean BMI values of the patients were 33.60±4.92 kg/m2 and 31.41±4.65 kg/m2 at the beginning and end of the hypnotherapy sessions respectively. Serum insulin levels were 15,89±8,19 μIU/mL at the beginning of the hypnotherapy sessions were 12.15±7.05 μIU/mL at the end of the hypnotherapy sessions. Insulin resistance were 3,81±2,27 at the beginning of the hypnotherapy sessions were 2.92±1.96 at the end of the hypnotherapy sessions. The results showed that BMI, serum insulin levels and insulin resistance decreased significantly after the hypnotherapy sessions. In addition, there were statistically significant correlation between the beginning and end of the hypnotherapy sessions FBG, serum insulin levels and insulin resistance. Conclusion: This study indicates that hypnotherapy in obesity treatment leads to weight loss in obese patients and thus to considerable changes in insulin resistance. Hypnotherapy is easy to apply, effective, has no for side effects, and can be applied both alone and in combination with other treatments.
Keywords: Obesity; hypnotherapi; weight loss; insulin resistance
REFERANSLAR:
- Oğuz G, Karabekiroğlu A, Kocamanoğlu B, Sungur MZ. [Obesity and cognitive behavioral therapy]. Current Approaches in Psychiatry. 2016;8(2):133-44.[Crossref]
- World Health Organization. The global health observatory.[Link]
- Sucaklı MH, Çelik M. [The etiology and epidemiology of obesity]. Türkiye Klinikleri J Fam Med-Special Topics. 2015;6(3):1-6.
- Memişoğulları R, Admış Ö. [The biochemistry of obesity]. Turkiye Klinikleri J Fam Med-Special Topics. 2015;6(3):14-21.
- Alamuddin N, Bakizada Z, Wadden TA. Management of obesity. J Clin Oncol. 2016;34(35):4295-305.[Crossref] [PubMed]
- Seong J, Kang JY, Sun JS, Kim KW. Hypothalamic inflammation and obesity: a mechanistic review. Arch Pharm Res. 2019;42(5):383-92.[Crossref] [PubMed]
- Brown JC, Harhay MO, Harhay MN. The value of anthropometric measures in nutrition and metabolism: comment on anthropometrically predicted visceral adipose tissue and blood-based biomarkers: a cross-sectional analysis. Nutr Metab Insights. 2019;12:1178638819831712.[Crossref] [PubMed] [PMC]
- Savaş HB, Gültekin F. [Insulin resistance and clinical significance]. Med J SDU. 2017;24(3):116-25.
- Henstridge DC, Abildgaard J, Lindegaard B, Febbraio MA. Metabolic control and sex: a focus on inflammatory-linked mediators. Br J Pharmacol. 2019;176(21):4193-207.[Crossref] [PubMed] [PMC]
- Laursen TL, Hagemann CA, Wei C, Kazankov K, Thomsen KL, Knop FK, et al. Bariatric surgery in patients with non-alcoholic fatty liver disease-from pathophysiology to clinical effects. World J Hepatol. 2019;11(2):138-49.[Crossref] [PubMed] [PMC]
- Freeman AM, Pennings N. Insulin resistance. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020.[PubMed]
- Baltacı D, Ünalacak M, Kara İH, Sarıgüzel Y. [Obesity treatment in primary care]. Turkiye Klinikleri J Fam Med-Special Topics. 2015;6(3):96-102.
- Mohammad T, Farzad N, Tagie GM, Ranjbar K. The impact of rapid weight loss on the leptin, adiponectin levels, and insulinresistance among adult free style wrestlers. J Sports Med Phys Fitness. 2015;55(7-8):805-12.[PubMed]
- Tzotzas T, Papadopoulou FG, Tziomalos K, Karras S, Gastaris K, Perros P, et al. Rising serum 25-hydroxy-vitamin D levels after weight loss in obese women correlate with improvement in insulin resistance. J Clin Endocrinol Metab. 2010;95(9):4251-7.[Crossref] [PubMed]
- Elkins GR, Barabasz AF, Council JR, Spiegel D. Advancing research and practice: the revised APA division 30 definition of hypnosis. Am J Clin Hypn. 2015;57(4):378-85.[Crossref] [PubMed]
- Spiegel H, Greenleaf M, Spiegel D. Hypnosis: an adjunct for psychotherapy. In: Sadock BJ, Sadock VA, Kaplan HI, eds. Kaplan & Sadock's Comprehensive Textbook of Psychiatry. 8th ed. Philadephia: Lippincott Williams & Wilkins; 2005. p.2548-68.
- Brugnoli MP. Clinical hypnosis for palliative care in severe chronic diseases: a review and the procedures for relieving physical, psychological and spiritual symptoms. Ann Palliat Med. 2016;5(4):280-97.[Crossref] [PubMed]
- Jensen MP, Patterson DR. Hypnotic approaches for chronic pain management: clinical implications of recent research findings. Am Psychol. 2014;69(2):167-77.[Crossref] [PubMed] [PMC]
- Lynn SJ, Laurence JR, Kirsch I. Hypnosis, suggestion, and suggestibility: an integrative model. Am J Clin Hypn. 2015;57(3):314-29.[PubMed]
- Sadock BJ, Sadock VA. Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2007.
- Goldstein RH. Hypnosis and pain: no longer an "alternative" clinical hypnosis for pain control. Clin J Pain. 2011;27(4):375-6.[Crossref]
- Set T, Avşar Ü. [Complementary and alternative medicine in obesity]. Turkiye Klinikleri J Fam Med-Special Topics. 2015;6(3):108-11.
- Entwistle PA, Webb RJ, Abayomi JC, Johnson B, Sparkes AC, Davies IG. Unconscious agendas in the etiology of refractory obesity and the role of hypnosis in their identification and resolution: a new paradigm for weight-management programs or a paradigm revisited? Int J Clin Exp Hypn. 2014;62(3):330-59.[Crossref] [PubMed]
- Milling LS, Gover MC, Moriarty CL. The effectiveness of hypnosis as an intervention for obesity: a meta-analytic review. Psychology of Consciousness: Theory, Research, and Practice. 2018;5(1):29-45.[Crossref]
- Mattehews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-9.[Crossref] [PubMed]
- Montgomery GH, Schnur JB, David D. The impact of hypnotic suggestibility in clinical care settings. Int J Clin Exp Hypn. 2011;59(3):293-309.[Crossref] [PubMed] [PMC]
- Wickramasekera I. Review of the international literature. Am J Clin Hypn. 2010;52(4):357-61.[Crossref]
- Pittler MH, Ernst E. Complementary therapies for reducing body weight: a systematic review. Int J Obes (Lond). 2005;29(9):1030-8.[Crossref] [PubMed]
- Stefan N, Häring HU, Schulze MB. Metabolically healthy obesity: the low-hanging fruit in obesity treatment? Lancet Diabetes Endocrinol. 2018;6(3):249-58.[Crossref] [PubMed]
- Hofsø D, Jenssen T, Bollerslev J, Ueland T, Godang K, Stumvoll M, et al. Beta cell function after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention. Eur J Endocrinol. 2011;164(2):231-8.[Crossref] [PubMed] [PMC]
- Bradley D, Conte C, Mittendorfer B, Eagon JC, Varela JE, Fabbrini E, et al. Gastric bypass and banding equally improve insulin sensitivity and β cell function. J Clin Invest. 2012;122(12):4667-74.[Crossref] [PubMed] [PMC]
- Magkos F, Fraterrigo G, Yoshino J, Luecking C, Kirbach K, Kelly SC, et al. Effects of moderate and subsequent progressive weight loss on metabolic function and adipose tissue biology in humans with obesity. Cell Metab. 2016;23(4):591-601.[Crossref] [PubMed] [PMC]
- Rothberg AE, Herman WH, Wu C, IglayReger HB, Horowitz JF, Burant CF, et al. Weight loss improves β-cell function in people with severe obesity and impaired fasting glucose: a window of opportunity. J Clin Endocrinol Metab. 2020;105(4):e1621-30.[Crossref] [PubMed] [PMC]
- Levenson M, Levenson D. Efficacy of self-hypnosis in type 2 diabetics with BMI ≥ 25: a randomized clinical trial. Endocrine Practice. 2018;24(Suppl 1):143-4.[Link]
- Deswita D, Sahar J, Mulyono S. [Impact of coaching and self-hypnosis intervention on blood glucose levels of older adults in Indonesia]. Enferm Clin. 2019;29 Suppl 2:146-50.[Crossref] [PubMed]
- Xu Y, Carde-a E. Hypnosis as an adjunct therapy in the management of diabetes. Int J Clin Exp Hypn. 2008;56(1):63-72.[Crossref] [PubMed]
- Ko HJ, Kim JH, Kim MJ. The impact of very low-calorie diet-induced weight loss on changes in the serum vitamin D levels, insulin resistance, and inflammatory biomarkers in overweight Korean women. J East Asian Soc Diet Life. 2019;29(3):238-52.[Crossref]
- McLaughlin T, Abbasi F, Lamendola C, Yee G, Carter S, Cushman SW. Dietary weight loss in insulin-resistant non-obese humans: metabolic benefits and relationship to adipose cell size. Nutr Metab Cardiovasc Dis. 2019;29(1):62-8.[Crossref] [PubMed] [PMC]
- McLaughlin T, Carter S, Schweitzer P, Chi-Gang Y, Lamendola C, Abbasi F, et al. Persistence of weight loss and associated metabolic benefits in insulin resistant, obese individuals following a weight loss program of relatively short duration. Diabetes Obes Metabol. 2008;10:1186-94.
.: İşlem Listesi