Open Access Research

Attachment style contributes to the outcome of a multimodal lifestyle intervention

Sybille Kiesewetter1*, Andrea Köpsel1, Knut Mai2, Andrea Stroux3, Thomas Bobbert2, Joachim Spranger2, Werner Köpp1, Hans-Christian Deter1 and Bettina Kallenbach-Dermutz1

Author Affiliations

1 Department of Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany

2 Department of Endocrinology, Diabetes and Nutrition, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany

3 Department of Epidemiology and Statistics, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany

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BioPsychoSocial Medicine 2012, 6:3  doi:10.1186/1751-0759-6-3

Published: 2 February 2012

Abstract

Background & Aims

The long-term success of life-style interventions in the treatment of obesity is limited. Although psychological factors have been suggested to modify therapeutic effects, specifically the implications of attachment styles and the patient-therapist relationship have not been examined in detail yet.

Methods

This study included 44 obese patients who participated in a one-year multimodal weight-reduction program. Attachment style was analyzed by the Adult Attachment Prototype Rating (AAPR) inventory and its relation to a one-year weight reduction program was studied. The patient-therapist-relationship was assessed using the Helping Alliance Questionnaire.

Results

Attachment style was secure in 68% of participants and insecure (preoccupied and dismissing) in 32%. Interestingly a significantly higher weight-reduction was found in securely (SAI) compared to insecurely attached individuals (UAI; p < 0.05). This estimation correlated positively also to the quality of helping alliance (p = 0.004).

Conclusions

The frequency of insecure attachment in obese individuals was comparable to that of the normal population. Our data suggest a greater weight-reduction for SAI than for UAI, and the patient-therapist relationship was rated more positively. The conclusion can be drawn that a patient's attachment style plays a role in an interdisciplinary treatment program for obesity and has an influence on the effort to lose weight.

Keywords:
attachment style; obesity; patient-therapist relationship; weight reduction