I'm a big fan of food, but not so much of working out. Is there any truth to the buzz I hear that hypnosis can help me lose weight?
—Megan, your very own office manager
Clearly, we're not keeping you busy enough. I expect you've heard this buzzing from our patient who has dropped a few pounds and attributes it to visiting her hypnotherapist. What you don't know—since you're not often in the treatment room—is that when I recently said the word "Thanksgiving," her eyes glazed over and she began to gobble like a turkey. Unsure that it was hypnosis-related, I hastily mentioned Mardi Gras without thinking it through. I'm now eternally grateful to my high school judo coach for teaching that masterful arm block that kept her from lifting her blouse up over her head.
Perhaps that's not fair. Hypnosis, of course, is more than just regressing stockbrokers back to preschool in front of a live audience. But, like any good skeptic, I must first question whether it is an authentic craft and whether the so-called trance has any validity. Apparently, the answer to both is yes (stage performers notwithstanding). A good amount of research—some using brain scans—demonstrates the existence of a distinct hypnotic state characterized by a combination of relaxation, concentration and suggestibility. It seems that the brain can actually switch into a condition in which it accepts, without verifying, incoming sensory information—temporarily muffling its typical decision-making abilities. Remarkably, there is little dispute over hypnosis as an effective palliative for chronic pain conditions (cancer, for example). The technique, too, shows promise for easing acutely painful procedures like bone-marrow aspiration or wound cleaning. But, like preschool naptime, not everyone goes down without a fight.
Susceptibility to hypnosis varies among individuals and is surprisingly unrelated to a person's gullibility, submissiveness or even the extent of their imagination. Careful personality analysis has shown that it is, instead, your capacity to become completely absorbed in activities like reading, daydreaming or listening to music that is the best measure of your hypnotic responsiveness. So if we accept that hypnosis is real, its usefulness for weight loss depends upon yet another presumption: A post-hypnotic suggestion must last, at the very least, through your next meal.
Post-hypnotic suggestions are those instructions given by the hypnotist that compel a person to, say, perform the chicken dance whenever someone sneezes. In weight control sessions, the guidance may include positive body image statements, fondness or aversion toward certain foods, or encouragement for exercise. Despite the myriad sitcoms showing people doing, essentially, the chicken dance days and days after being hypnotized, it is a not-so-public fact that post-hypnotic suggestions are generally short-lived and decay quickly. With this in mind, any promises of single-session, instant and dramatic weight loss should be filed under the category of wishes, not treatment.
However, hypnosis can work. Unfortunately for those who want a quick fix, it is only in combination with true psychotherapy that hypnosis has proven to be effective. For example, a 1998 randomized and controlled study found that, after measuring total weight lost, dietary advice with hypnotherapy only barely defeated that same advice alone. But added to real cognitive behavioral therapy, other investigations have found hypnotism to be a much more effective adjunct. The necessity for simultaneous psychotherapy suggests that conditions having significant behavioral components—like weight control, smoking or other addictions—are more resistant to hypnosis, whereas less complex issues such as anxiety or insomnia respond fairly quickly.
It should be noted that all the above research used one-on-one hypnosis by trained and certified therapists. Audio CDs or tapes providing guided self-hypnosis, with or without subliminal encoding, have not been proven to have any effect whatsoever—with the exception of a relaxation stupor sufficient for sleeping through dinner. Although testimonials abound on the Internet and elsewhere (including our own waiting room), a significant placebo effect may occur when a person truly believes a therapist or audiotape has changed their eating habits; it becomes a self-fulfilling prophecy. There is nothing inherently wrong with that, but individuals may sacrifice lasting benefit by avoiding responsibility for their own behavior.
Megan, becoming enthused about exercise would definitely be better than a hypnosis-only plan. And I can certainly help by finding some heavy file boxes for you to move and some exhausting errands to run. But don't let me stop you from combining hypnotherapy with a real weight-control program, though I'd love to speak with the therapist first. I can think of a number of patients who would pay top dollar to see you do the chicken dance.