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Secondary psychological outcomes in a controlled trial of Emotional Freedom Techniques and Cognitive Behaviour Therapy in the treatment of food cravings

Citation:  Stapleton, P., Bannatyne, A., Chatwin, H., Urzi, K., Porter B., Sheldon, T, Complementary Therapies in Clinical Practice, 28, 2017 (136-145)

Abstract

Objective: Examining the effectiveness of psychological interventions in treating secondary psychological outcomes of obesity has become prioritized in recent times. The objective of the present study was to compare an eight-week Cognitive-Behavioural Therapy (CBT) and Emotional Freedom Techniques (EFT) intervention program, in the treatment of food cravings and secondary psychological outcomes among overweight or obese adults (N . 83).

Method: A controlled non-inferiority trial was performed comparing group-delivered CBT to group-delivered EFT. Participants completed the Patient Health Questionnaire at pre- and post-intervention, and at six and 12-months follow-up.

Results: The CBT group did not report any significant changes in anxiety scores over time, but the decrease in depression symptoms pre-to post-intervention was significant and this was maintained at 6-and 12-months. Anxiety and depression scores significantly decreased from pre-to post-intervention for the EFT group, and was maintained at 6- and 12-month follow-up. Somatoform scores significantly decreased from pre-intervention to all follow-up points for the CBT group, while the EFT group did not report any significant changes in somatoform symptoms. Results also revealed that EFT is capable of producing reductions in anxiety and depression symptoms, and may be comparable to gold standard approaches such as CBT.

Conclusion: The current study supports the hypothesis that psychological intervention is beneficial for treating psychological comorbidities of obesity and points to the role mental health issues may play in this area.

Craig’s Notes

This study builds on previous studies that have shown both CBT and EFT to be helpful interventions for food cravings and weight loss. The researchers note that meta-analytic studies have found that rates of depression and anxiety are three to four times higher among obese individuals compared to their leaner peers. Since mood disorders are associated with poor treatment outcomes and diminished compliance for other health-related conditions, they see the importance of alleviating these conditions when designing weight loss programs.

Since so many trials have consistently shown both EFT and CBT to effective in treating various psychological conditions, including depression, anxiety and addiction, a sensible hypothesis is that they would be effective in treating these secondary psychological symptoms in people who experience food cravings and/or weight problems.

The recruitment process netted 83 participants who were placed randomly in an 8-week CBT treatment group, or an 8-week EFT intervention group. Each participant filled out a Patient Health Questionnaire which included five modules covering five common types of mental disorders, including depression, anxiety, somatoform, alcohol, and eating modules.

The researchers made sure that treatment protocols and fidelity plans for EFT and CBT were formed prior to the beginning of the study. Both interventions were offered in a group format with each group being 10-15 people. The interventions consisted of eight weekly sessions, each lasting two hours.

The CBT intervention aimed to modify eating, thinking, and activity levels by teaching group members cognitive and behavioral strategies, such as working with thoughts and beliefs, and the use of food diaries, relaxation skills and self-esteem exercises. Similar to the EFT intervention, the CBT intervention also involved direct exposure to craved foods to elicit associated emotions and cognitions. The EFT group worked with similar cognitive and behavioral strategies, and the major difference between the two treatments was the addition of the somatic tapping process in the EFT treatment.

So, what were the results? Both groups lost weight during the trial. The EFT group lost an average of 3.15 kg by the end of the study, which increased to 4.28 kg pre to 6-months, and then was maintained at 3.32 kg at the 12-month follow up. The CBT group was slower initially, losing 0.90 kg on average at the studies end, but this increased to 2.90 kg at 6-months, and 5.10 kg at 12-months. Both groups were able to achieve and sustain weight loss.

Although the CBT group experienced significantly lower anxiety scores at the end of the study, this effect was not maintained at 6-and 12-month follow-up points. Moreover, the EFT group reported significant decreases in scores from pre-intervention to 6- and 12-month follow-up, which is consistent with research demonstrating the delayed effect of EFT-based intervention in promoting improvements in psychological difficulties.

The two groups were not statistically significant in terms of depression scores at post-intervention or follow-up points. Moreover, the EFT group reported significant decreases in depression scores from pre-intervention to post-intervention and follow-up points.

Overall, findings indicated that group EFT- and CBT-based intervention are both effective in treating depressive, anxiety, and somatic symptoms among obese populations. They suggest that these modalities of psychological and somatic interventions can potentially lead to long-term maintenance of treatment gains.