Effects of a Cognitive-Behavioral Group Counseling Program on Weight Bias Internalization and Psychological Outcomes Among Obese Youth in Mahasarakham University, Thailand

Abstract

Background: Weight bias internalization (WBI) is a serious challenge because of its negative impact on psychological consequences. Although the cognitive-behavioral intervention has been applied to reduce WBI, little is known about its effectiveness among Thai obese youth. Thus, this study sought to determine the effects of a cognitive-behavioral group counseling (CBGC) program on WBI and psychological outcomes in obese youths. Study Design: A randomized controlled trial. Methods: Eighty obese youths were randomly allocated to two intervention (n = 40) and control (n = 40) groups. The intervention group received a CBGC program in three sessions with ten activities, while the control group performed their usual counseling process. Data were collected through standardized interviewers with a structured interview questionnaire. The chi-square test, independent samples t-test, Mann-Whitney U test, repeated measure ANOVA, and multivariate linear regression were applied for data analyses. Results: At the follow-up visit, the intervention group had a significant decrease in the mean of WBI, depression, and perceived stress and an increased mean of self-esteem compared to the control group. After adjusting baseline characteristics and baseline outcome values, the intervention also significantly improved WBI (B =-6.82, P < 0.001), depression (B =-4.17, P < 0.001), perceived stress (B =-6.01, P < 0.001), and self-esteem (B = 5.07, P < 0.001). Conclusion: The CBGC program effectively reduced WBI, depression, and perceived stress while improving self-esteem among obese youths. This study recommends that group counseling programs be employed as part of a counseling process for obese youth who have experienced WBI.