title: Impact of biofeedback on self-efficacy and stress reduction in obesity: a randomized controlled pilot study.
abstract: Biofeedback application is an evidence-based technique to induce relaxation. A primary mechanism of action is the improvement of self-efficacy, which is needed to facilitate the translation of health behavioral intentions into action. Obesity is often associated with low self-efficacy and dysfunctional eating patterns, including comfort eating as an inexpedient relaxation technique. This is the first study investigating the effects of biofeedback on self-efficacy and relaxation in obesity. In the present experiment, 31 women, mean body mass index 35.5 kg/m², were randomized to a food-specific biofeedback paradigm, a non-specific relaxation biofeedback paradigm, or a waiting list control. Eight sessions of biofeedback of the electrodermal activity were performed while presenting either a challenging food stimulus or a non-specific landscape stimulus. Self-efficacy, stress, ability to relax, eating behavior, and electrodermal activity were assessed before, directly after, and 3 months after the intervention. The food-specific biofeedback predominantly showed effects on food-related self-efficacy and perceived stress. The non-specific relaxation biofeedback showed effects on the ability to relax. Self-reported improvements were confirmed by corresponding decrease in the electrodermal reaction to food stimuli. Biofeedback treatment is effective in improving self-efficacy in individuals with obesity and might therefore be a valuable additional intervention in obesity treatment.
authors.affiliation: Department of Internal Medicine, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstrasse 5, 72076, Tübingen, Germany. martin.teufel@med.uni-tuebingen.de
authors.forename: Martin
authors.initials: M
authors.lastname: Teufel
authors.forename: Kerstin
authors.initials: K
authors.lastname: Stephan
authors.forename: Axel
authors.initials: A
authors.lastname: Kowalski
authors.forename: Saskia
authors.initials: S
authors.lastname: Käsberger
authors.forename: Paul
authors.initials: P
authors.lastname: Enck
authors.forename: Stephan
authors.initials: S
authors.lastname: Zipfel
authors.forename: Katrin E
authors.initials: KE
authors.lastname: Giel
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001676:Biofeedback, Psychology / Q000502:physiology*; D015992:Body Mass Index; D004435:Eating / Q000523:psychology; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D005502:Food; D005712:Galvanic Skin Response / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D010865:Pilot Projects; D012064:Relaxation Therapy; D020377:Self Efficacy; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology* / Q000628:therapy*; D013564:Sympathetic Nervous System / Q000502:physiology; D016896:Treatment Outcome