American Journal of Clinical Hypnosis

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Does hypnosis result in greater weight loss

compared to conventional approach?

Nurul Afiedia Roslim, Aryati Ahmad, Mardiana Mansor, Myat Moe Thwe
Aung, Farrahdilla Hamzah, Mohd Razif Shahril & Pei Lin Lua

To cite this article: Nurul Afiedia Roslim, Aryati Ahmad, Mardiana Mansor, Myat Moe Thwe Aung,
Farrahdilla Hamzah, Mohd Razif Shahril & Pei Lin Lua (2022): Does hypnosis result in greater
weight loss compared to conventional approach?, American Journal of Clinical Hypnosis, DOI:
10.1080/00029157.2021.2010642

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Published online: 02 Feb 2022.

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AMERICAN JOURNAL OF CLINICAL HYPNOSIS
https://doi.org/10.1080/00029157.2021.2010642

Does hypnosis result in greater weight loss compared to

conventional approach?
Nurul Afiedia Roslima, Aryati Ahmadb, Mardiana Mansorc, Myat Moe Thwe Aungc,
Farrahdilla Hamzahc, Mohd Razif Shahrild, and Pei Lin Luaa
a
Universiti Sultan Zainal Abidin (UniSZA), Besut, Malaysia; bUniversiti Sultan Zainal Abidin (UniSZA), Kuala
Nerus, Malaysia; cUniversiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Malaysia; dUniversiti Kebangsaan
Malaysia, Kuala Lumpur, Malaysia

ABSTRACT KEYWORDS
Hypnosis has been increasingly used in recent years as an alternative Complementary and
treatment to maintain well-being. Yet, limited evidence is available alternative therapies;
regarding its role in weight management, especially in Malaysia. hypnosis; hypnotherapy;
obesity; overweight; weight
Hence, this quasi-experimental study was conducted to evaluate the
loss
effectiveness of hypnosis on weight loss and body composition (body
mass index, waist circumference and body fat percentage) among staff
and students of a public university in Terengganu, Malaysia. Participants
with body mass index (BMI) ≥ 25.0 kg/m2 were randomly assigned to
either intervention group (IG = 53) or control group (CG = 54), for
12 weeks. All participants received health education (diet + exercise +
behavioral recommendations) with those in IG had additional three
hypnotherapy sessions, once a month. Body weight was measured at
week 1, 7, and 12 while body compositions were measured at weeks 1
and 12. Descriptive, univariate, and repeated-measures analysis of cov­
ariance (ANCOVA) were utilized. A total of 104 participants completed
the trial (mean age = 26.28 ± 8.01; female = 82.2%; BMI = 31.39 ± 4.89).
A significant weight loss was observed in the intervention (−4.61%) and
control (−3.04%) groups (mean difference = −1.57; 95%CI: −2.59, −0.54;
p = .003) after 12 weeks. Participants that frequently practiced self-
hypnosis lost more weight (−6.27%; t(50) = −5.331, p < .001). Body fat
percentage and waist circumference did not significantly change from
baseline in both groups. Essentially, the positive outcomes indicated the
promising potential of hypnosis as an alternative tool in facilitating
weight loss efforts for those in need.

Overweight and obesity exert widespread effects on health and well-being through
a combination of excess fat mass and various adipose tissue depots’ physiologic or endo­
crine actions. This phenomenon causes a global burden, accounting for at least 2.8 million
people dying each year due to health conditions related to excess weight (World Health
Organization [WHO], 2021). The global burden continues to increase, and it has been
estimated that 2.16 billion (38%) of the world’s adult population will be overweight, and
1.12 (20%) will be obese by 2030 (Finkelstein et al., 2012). In Malaysia, the National Health
and Morbidity Survey 2019 found that overweight and obesity among adults were 30.4%
and 19.7%, respectively. Furthermore, Malaysia was ranked first among Southeast Asian

CONTACT Pei Lin Lua [email protected] Faculty of Pharmacy, Universiti Sultan Zainal Abidin (UniSZA),
Kampus Besut, Besut, Terengganu 22200.
© 2022 American Society of Clinical Hypnosis
2 N. A. ROSLIM ET AL.

countries with the highest obesity rate in adults (Mohd-Sidik, Lekhraj, & Foo, 2021).
Obesity prevention is imperative to prevent further increase as excess weight problems
have adverse consequences, including type 2 diabetes mellitus, hypertension, cardiovascular
diseases, sleep apnea and certain type of cancers (Javaid, Omar, Shah, & Ahmad, 2021).
Obesity prevention and treatment are commonly based on lifestyle modifications (i.e.,
reduced calorie intake or increased physical activity); however, this conventional approach
is typically ineffective, and most individuals struggle to achieve and sustain clinically healthy
weight loss for the long-term (Abdul Manaf, Ahmad, & Mohd Yusoff, 2018; Bellicha et al.,
2021; Mann et al., 2007). In addition, individuals are often concerned about drug toxicity
and the side effects of anti-obesity medications and endoscopic/surgical bariatric therapies
(Tak & Lee, 2021). Therefore, this poses a higher demand for seeking alternative ways to
improve health, and about 70% of people worldwide are found to use complementary and
alternative therapies (CATs). However, there is insufficient scientific assessment evidence to
prove its safety and effectiveness (Ernst, 2000).
According to the National Center for Complementary and Alternative Medicine
(NCCAM), CATs is an umbrella term describing a range of health systems, modalities,
and practices that are not generally considered part of conventional medicine. The reported
global prevalence of CATs use ranges from 9.8% to 76.0%, while the prevalence of CATs
uses among Malaysians was 69.4%, with herbal and dietary supplements being the most
popular choice (Harris, Cooper, Relton, & Thomas, 2012; Siti et al., 2009). In weight
management care, the use of CATs is becoming increasingly popular, and more than 50%
of patients considered joining any CATs-based approach to lose their weight (Lua et al.,
2021). Scientific evidence indicates that some CATs (e.g. hypnotherapy, acupuncture,
mindfulness, herbal, and dietary supplements) may help to reduce body weight (Bo et al.,
2018; Esteghamati, Mazaheri, Rad, & Noshad, 2015).
Hypnosis (i.e. a process that uses a trance-like state to bring about positive changes in an
individual) is a particular alternative approach that gained attention as an adjunct to weight
loss strategies (Bo et al., 2018; Bolocofsky, Spinler, & Coulthard-Morris, 1985). Generally,
hypnosis enhances motivation, improves eating behavior, and effectively fights excess
weight problems (Gelo et al., 2014; Sapp, Obiakor, Scholze, & Gregas, 2007).
Furthermore, as Erşan and Erşan (2020) claimed, this therapy is easy to apply, inexpensive,
noninvasive, and generally lacks the potential of adverse effects. However, the clinical
evidence justifying its use is still debatable, and studies that addressed this therapy within
our local settings is also notably lacking. This study, therefore, aimed to evaluate the
effectiveness of hypnosis on body weight as well as body composition (BMI, waist circum­
ference [WC] and body fat percentage [BF%]) among overweight and obese individuals in
a public university in Malaysia.

Materials and methods

Ethical approval
This research has been approved by the UniSZA Human Research Ethics Committee
(UHREC) with a study protocol code of UniSZA/UHREC/2019/116. The participants
were given a verbal briefing and had their queries resolved about the study. Written consent
was obtained from participants prior to their enrollment.
 AMERICAN JOURNAL OF CLINICAL HYPNOSIS 3

Study design and sample selection

The pre- and post-test quasi-experimental study was conducted in Kampus Gong Badak,
Kampus Besut and Kampus Perubatan, Universiti Sultan Zainal Abidin (UniSZA),
Terengganu, Malaysia, among overweight and obese individuals. In this study, 107 staff and
students were conveniently sampled and recruited. The sample size was calculated using
G*Power software version 3.1 with a significance level at 0.05, 80% power, 20% of attrition rate
and effect size g of 0.15 based on the general recommendations for experimental study and
advice from statistician (Faul, Erdfelder, Lang, & Buchner, 2007; Schäfer & Schwarz, 2019).
Eligible participants were randomized either to the intervention group (hypnosis + standard
lifestyle modifications, i.e., diet + exercise + behavioral recommendation) or the control group
(standard lifestyle modifications). The random assignment was made sequentially from an
Excel’s random number generator with a ratio of 1:1 to the two groups to prevent selection
bias. Figure 1 depicts the recruitment process and the reasons for the exclusion or disconti­
nuation of participants using CONSORT flow diagram (Moher et al., 2012).
Participation was entirely voluntary, and the selection of samples was essential to ensure
that they met the study’s requirements. The inclusion criteria included staff and students
aged 18 years or older who had a BMI greater than 25 kg/m2 and understood and wrote in

Enrollment Assessed for eligibility

(n = 121)

Excluded (n = 14)
• Not meeting inclusion criteria
(n = 10)
• Declined to participate (n = 10)

Randomized (n = 107)

Allocation
Intervention group
Control group (n = 54)
(n = 53)

Follow-Up
Lost to follow-up (pregnant) Lost to follow-up (pregnant) (n = 1)
(n = 1) Discontinued intervention (residence
change) (n = 1)

Analysis
Analysed Analysed
(n = 52) (n = 52)

Figure 1. CONSORT flow diagram of the study.

4 N. A. ROSLIM ET AL.

Malay or English. Meanwhile, participants were excluded if they had underlying chronic
health conditions requiring regular medication such as hemodialysis or organ failure, had
been diagnosed with psychological issues or hearing impairment, were pregnant or post-
menopausal, or were currently involved in another weight management program.

Data collection method

Upon recruitment, eligible subjects who gave written consent were briefed about this
study and were first asked to complete a self-administered demographic questionnaire at
baseline. The anthropometric measurements (height, WC and BF%) were assessed at
baseline and three months later, while weight was measured at weeks 1, 7 and 12. All
participants in both groups received health education covering various aspects of diet,
exercise, and tips for diet adherence (e.g., do not buy foods on an empty stomach,
properly chew the food before swallowing) were given to all patients once a month (at
Week 1, 7 and 12). During health education sessions, participants were asked about
adverse events and compliance with the intervention. During the study, those who were
pregnant or changed residence (unable to attend the next session) were considered
dropouts. Each participant then received a token of appreciation after going through
the whole procedure at the end of the study.

Intervention
In addition to health education, participants in the intervention group received three
hypnosis sessions, a month apart (week 1, 7 and 12), performed by a trained and
qualified hypnotherapist. The 30-minute hypnosis session was conducted in Malay and
held in a comfortable room at an academic building. During the first session, the
hypnosis procedure, information, and its potential effects were briefly explained.
Thereafter, a rapid induction technique was used to increase the sense of relaxation
and enabled participants to go into a hypnotic condition in a few minutes (Bo et al.,
2018). After deepening was achieved, ego-strengthening techniques with positive sug­
gestions to have a healthy and balanced diet were applied. Then, participants were
brought out of the hypnosis state during the realerting phase. Finally, the participants
were taught and encouraged to practice self-hypnosis using the same techniques daily.
The positive suggestions were emphasized again during subsequent sessions at week 7
and 12 of the study. In addition, participants were reminded to do self-hypnosis
during their follow-up sessions.

Measurements
Baseline demographic and anthropometric measurements were obtained from participants
to accomplish the objectives.

Sociodemographic data
This form consisted of several basic information regarding participants’ demographic
characteristics such as age, gender, ethnicity, educational level, marital status, and income.
 AMERICAN JOURNAL OF CLINICAL HYPNOSIS 5

Anthropometrics measurements
Anthropometric measurements were conducted with respondents in light clothing,
without shoes, and assessed according to the WHO protocol (WHO, 1995). Height,
weight, BF% and WC measurements were taken in an upright standing position to
the nearest 0.1 cm and 0.1 kg by using Seca 213 portable stadiometer (Seca,
Germany), TANITA Model BC-583 digital weighing scale (TANITA, Japan) and
Seca 201 measuring tape (Seca, Germany), respectively. The body weight and height
were used for BMI calculations according to the formula BMI = weight (kg)/height2
(m2). The BMI was categorized according to WHO Expert Consultant (2004) cutoff
points as such: (a) normal: 18.5–24.9 kg/m2, (b) overweight: 25.0–29.9 kg/m2, (c)
obese type I: 30.0–34.9 kg/m2, (d) obese type II: 35.0–39.9 kg/m2, and (e) obese
type III: >40.0 kg/m2. The BF% was defined as unhealthy ≥ 25% for men and ≥ 35%
for women (WHO, 1995). The cutoff points for waist circumference (men ≥ 94 cm;
women ≥ 80 cm) were used to determine abdominal obesity among participants.
All measurements were measured twice, and the average values were used in the
analysis.

Statistical analyses
The collected data were analyses using the IBM (SPSS Statistics for Windows)
Version 23.0 (Armonk, NY, US). Descriptive statistics were employed to summarize
the demographic characteristics and anthropometric measurements presented using
frequencies (n) and percentages (%). Independent samples t-test was used to deter­
mine the differences between the groups (IG and CG) for continuous variables while
chi-square test was used to determine the association between categorical variables at
the pre-intervention. The univariate and repeated-measures analysis of covariance
(ANCOVA) was used to assess the impact of hypnotherapy on the measures between
groups (IG and CG) with pre-intervention variables, age, and gender as covariances.
The Bonferroni adjustments were used when necessary and a p-value of < .05 was
considered statistically significant.

Results
Characteristics of the participants
A total of 107 staff and students were enrolled and randomized: 53 into the interven­
tion group and 54 into the control group. At 12 weeks, three individuals withdrew
(one from the intervention group and two from the control group), providing a total
of 104 completed participants for data analyses. The majority of the participants were
female (82.2%) and Malays (98.1%) with a mean age of 26.3 years (SD = 8.0). Of them,
71.0% were students (94 undergraduates, 13 postgraduates), unmarried (72.7%) and
had no income (57.9%). Based on the WHO classification, 54.2% were obese, while the
other 45.8% were overweight. There were no statistically significant differences in
sociodemographic, body weight, BMI, BF%, and WC variables between the IG and
CG at baseline. Sociodemographic characteristics of the participants at the time of
enrollment are given in Table 1.
6 N. A. ROSLIM ET AL.

Table 1. Sociodemographic characteristics of participants at baseline (n = 107).

Characteristics IG (n = 53) CG (n = 54) p-valuea
Age (years); Mean ± SD 26.3 ± 8.53 26.2 ± 7.55 .323
Gender, n (%)
Male 10 (9.3%) 9 (8.4) .766
Female 43 (40.2) 45 (42.1)
Ethnicity
Malay 51 (47.7) 54 (100.0) .243
Sabahan 2 (1.9) 0
Marital status
Single 36 (33.6) 42 (53.8) .252
Married 17 (15.9) 12 (11.2)
Educational level
Pre-University 17 (15.9) 20 (18.7) .108
Degree 26 (24.3) 31 (29.0)
Master’s degree/PhD 10 (9.3) 3 (2.8)
Occupation
Staff 17 (15.9) 14 (13.1) .483
Student 36 (33.6) 40 (37.4)
Income
No income 30 (28.0) 33 (30.8) .620
B40 (≤RM 2,500–RM 4,849/USD 608–USD 1,179) 16 (15.0) 12 (11.2)
M40 (RM 4,850–RM 10,959/USD 1180–USD 2,666) 7 (6.5) 9 (8.4)
Baseline BMI Status; Mean ± SD 31.3 ± 5.0 31.5 ± 4.8 .816
Overweight (BMI: 25.0–29.9 kg/m2) 27 (25.2) 22 (20.6)
Obese type I (BMI: 30.0–34.9 kg/m2) 11 (10.3) 21 (19.6)
Obese type II (BMI: 35.0–39.9 kg/m2) 12 (11.2) 7 (6.5)
Obese type III (BMI: > 40.0 kg/m2) 3 (2.8) 4 (3.7)
Baseline waist circumference (cm); Mean ± SD 91.7 ± 14.1 95.3 ± 13.7 .181
Baseline body fat percentage (%); Mean ± SD 37.3 ± 9.8 37.6 ± 9.5 .896
Data are presented as n (%) or mean ± standard deviation (SD)
a
p-values generated from independent t-test or Pearson chi-square test where appropriate.
*Significant difference (p < .05)

Changes in body weight and body composition

Table 2 shows the differences from baseline to post-intervention in each outcome (body
weight, BMI, BF%, and WC) for each group. Those in IG reported a significantly greater
reduction in body weight (mean weight loss = 3.68 kg or 4.61% of their baseline weight (p =
.003), compared with CG (mean weight loss = 2.30 kg or 3.04%). There was a statistically
significant differences in BMIs between groups at post-study after adjusting for baseline
BMI, age, and gender (adjusted mean difference = −0.31 kg/m2, 95% CI = −0.61, −0.02; p =
.034). Regarding the BF% and WC variables, the differences from baseline to post-study
were not significant between the groups (BF%, p = .081; WC, p = .611).
On the other hand, 24 participants from IG (45.3%) claimed to practice self-hypnosis more
than once per day, while 28 (52.8%) claimed to practice it rarely or never (Table 3). Those who
practiced self-hypnosis on a regular basis lost statistically significant body weight (−6.27 ±
2.26%) compared to those non-practicing (−3.14 ± 1.97%), t (50) = −5.331, p < .001. However,
no significant association was evident with the BF% and WC variables.

Discussion
Hypnosis is a mind-body interaction involving focused attention that could reinforce
a healthy eating behavior and has been shown to be an effective, alternative adjunct tool
to combat overweight and obesity problems (Bo et al., 2018; Milling, Gover, & Moriarty,
 AMERICAN JOURNAL OF CLINICAL HYPNOSIS 7

Table 2. Mean values and between-group differences for % weight loss, BW and body composition
(n = 104).
Post
Variable (s) Pre-mean (SD) Adjusted mean (95% CI)a Adjusted mean difference (95% CI)b p-value
% weight loss
IG − −4.61 (−5.33, −3.88) −1.57 (−2.59, −0.54) .003*
CG − −3.04 (−3.77, −2.31)
Body weight
IG 79.39 (15.3) 75.31 (74.75, 75.86) −0.81 (−1.49, −0.13) .021*
CG 79.50 (4.8) 76.70 (76.15, 77.26)
BMI
IG 31.26 (5.0) 29.73 (29.50, 29.97) −0.31 (−0.61, −0.02) .034*
CG 31.53 (4.8) 30.28 (30.04, 30.51)
BF%
IG 37.3 (9.8) 37.24 (36.86, 37.64) −0.48 (−1.04, −0.06) .081
CG 37.6 (9.5) 37.73 (37.35, 38.11)
WC (cm)
IG 91.7 (14.1) 90.05 (88.92, 91.17) −0.41 (−2.00, 1.18) .611
CG 95.3 (13.7) 90.45 (89.33, 91.58)
a
Adjusted mean using analysis of covariance after controlling for age, gender and baseline values
b
Bonferroni adjustment for 95% confidence interval (CI) for difference
*Significant different (p < .05)

Table 3. Summary of self-hypnosis use and variable changes in the IG (n = 52).

Mean (SD)
Rarely
Variable (s) ≥ once/day /never Mean difference (95% CI) t statistics (d.f) p-value
% weight loss −6.3 (2.3) −3.1 (1.9) −3.13 (−4.33, −1.94) −5.275 (46) <.001*
BF% 35.6 (9.8) 35.7 (11.7) −0.72 (−6.05, 5.90) −0.024 (49) .981
WC (cm) 90.0 (12.4) 87.1 (13.1) 2.90 (−4.21, 10.01) 0.820 (49) .416
*Significant different (p < .05).

2018). In our study, those in the hypnosis group showed a greater reduction in body weight,
BMI, BF% and WC post-study than their control counterparts, consistent with the findings
of previous similar studies (Bo et al., 2018; Erşan & Erşan, 2020; Rini, Hardika, & Suryani,
2020). The statistically significant decrement in body weight among participants in the IG
after controlling the baseline values, age and gender (with mean weight loss of 3.68 kg)
showed that these findings could offer supportive measures to explore the effectiveness of
hypnosis in combating obesity among Malaysians. Nevertheless, those in IG who practice
self-hypnosis frequently lost much more weight (mean weight loss of 5.12 kg) than those
who used it occasionally or never.
These weight loss differences between the groups with and without hypnosis are
generally smaller, which is well below the criteria of clinically significant weight loss
(CWL) than those typically reported in previous research (range from 4 to 8 kg) (Bo
et al., 2018; Bolocofsky et al., 1985). Similarly, other psychological approaches on
weight loss found that CWL is unlikely to occur following the intervention, most
likely due to no or minimum physical activity suggestions (Mercado et al., 2021; Olson
& Emery, 2015). The American College of Sports Medicine claims that participants
with excess weight are more likely to reach the CWL threshold if they undertake
aerobic exercise training at levels consistent with public health guidelines on physical
activity (Donnelly et al., 2009). However, the present study was considerably brief (a
8 N. A. ROSLIM ET AL.

2-hour session once a month), which was less demanding and easy to implement. This
is in contrast to the weekly hypnosis sessions that were generally employed in previous
studies (i.e., Bolocofsky et al., 1985; Gelo et al., 2014). In addition, prior trials were
limited (mainly from the 90s) and lacked a rigorous methodology (based on case
studies, small cohorts, and variability in techniques), emphasizing the relevance of
further exploring this issue.
Furthermore, the relaxation and suggestion techniques utilized during the hypnosis
session in this study helped the IG participants to reduce their weight consistently
every week. Previous evidence supported this, demonstrating that obese patients
experienced consistent weight loss after undergoing hypnosis sessions (Erşan &
Erşan, 2020). In addition, the hypnosis script included suggestions for healthier eating
and simple exercise to help reduce body weight and boost motivation among partici­
pants. The successful use of incorporating healthy lifestyle modifications in hypnosis to
assist weight loss is supported by previous studies that found that those who undergo
hypnosis showed changes in eating and exercise habits after the intervention phase
than those receiving conventional approach only (Bo et al., 2018; Bolocofsky et al.,
1985). Gelo et al. (2014) also reported significant eating behavior improvements after
undergoing hypnotherapy for 6 months. Thus, it is conceivable that hypnosis could
help improve lifestyle behavior and facilitate weight loss.
Additionally, hypnosis has been associated with enhanced capacity and a higher ability
for responding to suggestions (Elkins, Barabasz, Council, & Spiegel, 2015). Hypnotized
individuals are more likely to immerse themselves in the weight-losing paradigm (reduce
calorie consumption and increase physical activity) offered to them and to follow the
hypnotherapist’s recommendations than those who have not been hypnotized. As
Barabasz and Spiegel (1989) claimed, hypnosis allows individuals to alter their responses
and act in accordance with their goals (i.e., desire for certain types of food, recognizing
bodily signals of hunger and fullness to prevent overeating). Accordingly, few researchers
have demonstrated that hypnotherapy improves eating habits and eliminates unpleasant
food cravings (Erşan & Erşan, 2020; Milling et al., 2018). It is possible that these results
support the hypnotherapist’s ability to modify and change unfavorable dietary habits and
reinforce a new ideology during the hypnotherapy session, which could boost motivation
and self-control in reducing impulsiveness and overeating (Pellegrini et al., 2021). However
further research will be required to prove that there is a causal link, since these results are
also consistent with other interpretations.
On a separate issue, a non-significant reduction of obesity indices such as the BF% and WC
were denoted among the two groups after the 12 weeks of study. Our findings corroborate
earlier research that found no significant differences in BF% and WC variables between arms
following a weight loss program among people with obesity (Bo et al., 2018). The lack of
significant changes in these variables could be attributable to the study’s short duration and
lack of intensive dietary and physical activity guidelines. It is also likely that three hypnother­
apy sessions might have been insufficient to accomplish a substantial reduction in BF% and
WC, therefore the subject of the optimal number of sessions to achieve a significant reduction
should be investigated further. As in this study, those who regularly use self-hypnosis lost
body weight more consistently compared with those practicing rarely or not at all. This
underscores the importance of self-hypnosis as a reinforcement tool to support weight
management.
 AMERICAN JOURNAL OF CLINICAL HYPNOSIS 9

The strengths of this present study include the novelties of using population-based data
and integrating the new alternative approach of combating overweight and obesity pro­
blems in Malaysia. In addition, the application of hypnosis may result in positive improve­
ments related to healthy lifestyles among this cohort. However, several drawbacks in this
study had to be acknowledged. For example, the involvement of only one study location and
the adoption of convenience sampling during recruitment might not be entirely represen­
tative of all people with overweight and obesity.

Conclusion
Generally, this study suggests that over a 12-week duration of hypnotherapy, there was
a statistically significant weight reduction between the treatment and control group.
Participants also exhibited minimal, non-significant, between-group improvement of BF
% and WC. The outcomes from this study may contribute to the early indicator for the
design of more extensive, long-term upcoming research to reconfirm the effectiveness of
hypnosis in combating excess weight problems.

Acknowledgments
We gratefully acknowledged all the participants who had been involved in this study. The study was
supported by a research grant from Universiti Sultan Zainal Abidin – UniSZA Mentor-Mentee
Research Grant (R0046-R001).

Disclosure statement
No potential conflict of interest was reported by the author(s).

Funding
This research was supported by a grant from the Mentor Mentee Research Grant UniSZA;UniSZA
Mentor Mentee Research Grant [R0046-R001];

References
Abdul Manaf, N. U., Ahmad, A., & Mohd Yusoff, N. A. (2018). A systematic review on long term
effects of weight loss diet on body weight and lipid profile: Findings from randomized controlled
trials. Universal Journal of Public Health, 6(2), 40–48. doi:10.13189/ujph.2018.060202
Barabasz, M., & Spiegel, D. (1989). Hypnotizability and weight loss in obese subjects. International
Journal of Eating Disorders, 8(3), 335–341. doi:10.1002/1098108X
Bellicha, A., van Baak, M. A., Battista, F., Beaulieu, K., Blundell, J. E., Busetto, L., . . . Oppert, J. M.
(2021). Effect of exercise training on weight loss, body composition changes, and weight main­
tenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies.
Obesity Reviews, 22 Suppl 4, e13256. doi:10.1111/obr.13256
Bo, S., Rahimi, F., Goitre, I., Properzi, B., Ponzo, V., Regaldo, G., . . . Broglio, F. (2018). Effects of self-
conditioning techniques (Self-hypnosis) in promoting weight loss in patients with severe obesity:
A randomized controlled trial. Obesity, 26(9), 1422–1429. doi:10.1002/oby.22262
10 N. A. ROSLIM ET AL.

Bolocofsky, D. N., Spinler, D., & Coulthard-Morris, L. (1985). Effectiveness of hypnosis as an adjunct
to behavioral weight management. Journal of Clinical Psychology, 41(1), 35–41. doi:10.1002/1097-
4679(198501)41:1<35::AID-JCLP2270410107>3.0.CO;2-Z
Donnelly, J. E., Blair, S. N., Jakicic, J. M., Manore, M. M., Rankin, J. W., & Smith, B. K. (2009).
Appropriate physical activity intervention strategies for weight loss and prevention of weight
regain for adults. Medicine & Science in Sports & Exercise, 41(2), 459–471. doi:10.1249/
MSS.0b013e3181949333
Elkins, G. R., Barabasz, A. F., Council, J. R., & Spiegel, D. (2015). Advancing research and practice:
The revised APA division 30 definition of hypnosis. American Journal of Clinical Hypnosis, 57(4),
378–385. doi:10.1080/00029157.2015.1011465
Ernst, E. (2000). Prevalence of use of complementary/alternative medicine: A systematic review.
Bulletin of the World Health Organization, 78(2), 258–266.
Erşan, S., & Erşan, E. E. (2020). Effects of hypnotherapy on weight loss and thus on Serum Leptin,
Adiponectin, and Irisin levels in obese patients. The Journal of Alternative and Complementary
Medicine, 26(11), 1047–1054. doi:10.1089/acm.2020.0104
Esteghamati, A., Mazaheri, T., Rad, M. V., & Noshad, S. (2015). Complementary and alternative
medicine for the treatment of obesity: A critical review. International Journal of Endocrinology and
Metabolism, 13(2). doi:10.5812/ijem.19678
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G* Power 3: A flexible statistical power
analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods,
39(2), 175–191. doi:10.3758/BF03193146
Finkelstein, E. A., Khavjou, O. A., Thompson, H., Trogdon, J. G., Pan, L., Sherry, B., & Dietz, W.
(2012). Obesity and severe obesity forecasts through 2030. American Journal of Preventive
Medicine, 42(6), 563–570. doi:10.1016/j.amepre.2011.10.026
Gelo, O. C. G., Zips, A., Ponocny-Seliger, E., Neumann, K., Balugani, R., & Gold, C. (2014).
Hypnobehavioral and hypnoenergetic therapy in the treatment of obese women: A pragmatic
randomized clinical trial. International Journal of Clinical and Experimental Hypnosis, 62(3),
260–291. doi:10.1080/00207144.2014.901055
Harris, P. E., Cooper, K. L., Relton, C., & Thomas, K. J. (2012). Prevalence of complementary
and alternative medicine (CAM) use by the general population: A systematic review and
update. International Journal of Clinical Practice, 66(10), 924–939. doi:10.1111/j.1742-
1241.2012.02945.x
Javaid, A., Omar, N., Shah, M. S. M., & Ahmad, R. (2021). Obesity and co-morbidities review:
Inseparable associations. International Medical Journal, 28(1), 40–43.
Lua, P. L., Roslim, N. A., Ahmad, A., Mansor, M., Aung, M. M. T., & Hamzah, F. (2021). Utilisation
and perception of complementary and alternative therapies (CATs) among obese and overweight
individuals in a Malaysian Public University. IIUM Medical Journal Malaysia, 20(2). doi:10.31436/
imjm.v20i2.1358
Mann, T., Tomiyama, A. J., Westling, E., Lew, A. M., Samuels, B., & Chatman, J. (2007). Medicare’s
search for effective obesity treatments: Diets are not the answer. American Psychologist, 62(3), 220.
doi:10.1037/0003-066X.62.3.220
Mercado, D., Robinson, L., Gordon, G., Werthmann, J., Campbell, I. C., & Schmidt, U. (2021). The
outcomes of mindfulness-based interventions for obesity and binge eating disorder: A
meta-analysis of randomised controlled trials. Appetite, 166, 105464. doi:10.1016/j.
appet.2021.105464
Milling, L. S., Gover, M. C., & Moriarty, C. L. (2018). The effectiveness of hypnosis as an intervention for
obesity: A meta-analytic review. Psychology of Consciousness: Theory, Research, and Practice, 5(1), 29.
Mohd-Sidik, S., Lekhraj, R., & Foo, C. N. (2021). Prevalence, associated factors and psychological
determinants of obesity among adults in Selangor, Malaysia. International Journal of
Environmental Research and Public Health, 18(3), 868. doi:10.3390/ijerph18030868
Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., . . .
Altman, D. G. (2012). CONSORT 2010 explanation and elaboration: Updated guidelines for
reporting parallel group randomised trials. International Journal of Surgery, 10(1), 28–55.
doi:10.1016/j.ijsu.2011.10.001
 AMERICAN JOURNAL OF CLINICAL HYPNOSIS 11

Olson, K. L., & Emery, C. F. (2015). Mindfulness and weight loss: A systematic review. Psychosomatic
Medicine, 77(1), 59–67. doi:10.1097/PSY.0000000000000127
Pellegrini, M., Carletto, S., Scumaci, E., Ponzo, V., Ostacoli, L., & Bo, S. (2021). The use of self-help
strategies in obesity treatment. A narrative review focused on hypnosis and mindfulness. Current
Obesity Reports, 1–14. doi:10.1007/s13679-021-00443-z
Rini, M. T., Hardika, B. D., & Suryani, K. (2020). Penurunan Berat Badan pada Remaja Obesitas
Menggunakan Hipnoterapi. Jurnal Keperawatan Silampari, 4(1), 135–141. doi:10.31539/jks.
v4i1.1604
Sapp, M., Obiakor, F. E., Scholze, S., & Gregas, A. J. (2007). Confidence intervals and hypnosis in the
treatment of obesity. Australian Journal of Clinical Hypnotherapy & Hypnosis, 28(2), 25–33.
Schäfer, T., & Schwarz, M. A. (2019). The meaningfulness of effect sizes in psychological research:
Differences between sub-disciplines and the impact of potential biases. Frontiers in Psychology, 10,
813. doi:10.3389/fpsyg.2019.00813
Siti, Z. M., Tahir, A., Farah, A. I., Fazlin, S. A., Sondi, S., Azman, A. H., . . . Zaleha, W. W. (2009). Use
of traditional and complementary medicine in Malaysia: A baseline study. Complementary
Therapies in Medicine, 17(5–6), 292–299. doi:10.1016/j.ctim.2009.04.002
Tak, Y. J., & Lee, S. Y. (2021). Anti-obesity drugs: Long-term efficacy and safety: An updated review.
The World Journal of Men’s Health, 39(2), 208. doi:10.5534/wjmh.200010
WHO. (1995). Physical status: The use and interpretation of anthropometry (Report of a WHO Expert
Committee).
WHO Expert Consultation. (2004). Appropriate body-mass index for Asian populations and its
implications for policy and intervention strategies. Lancet, 363(9403):157–163.
World Health Organization (WHO). (2021). Obesity. Geneva: WHO.