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Hypnotherapy for overweight and obese patients: A narrative review

Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F, Hassan H, et al.

J Integr Med, 2021 Jan;19(1):1-5.
PMID: 33162374 DOI: 10.1016/j.joim.2020.10.006

Obesity and overweight problems are serious global health issues today and despite many efforts, the prevalence has continued to rise for decades. Interestingly, hypnotherapy has been gaining recognition as an effective treatment for obesity and overweight problems. This review compiles contemporary scientific research on the effectiveness of hypnotherapy for weight reduction. Scopus, PubMed and EBSCO Host databases were applied in the study. The search identified 119 articles, of which seven met the inclusion criteria. A total of 539 respondents (82.7% women and 17.3% men) between the ages of 17 and 67 years were represented in the seven studies. Most studies incorporated lifestyle changes, such as changes of dietary habit and behavioral recommendations in the hypnotic procedure. Their results suggested that the use of hypnotherapy not only promoted weight reduction during the treatment period but also after treatment cessation, and in some cases, one to ten kilograms were lost during follow-up periods. In addition, one study even showed increased physical activity among the hypnotised individuals. This use of hypnotherapy also improved respondents' eating behavior and quality of life. However, a definitive conclusion could not be drawn due to several methodological flaws and the limited number of published studies in this area. Therefore, further well-designed studies are needed to substantiate the effectiveness of hypnotherapy for this modern-day health problem.
Use and toxicity of traditional and complementary medicine among patients seeking care at an emergency department of a teaching hospital in Malaysia

Jatau AI, Aung MMT, Kamauzaman THT, Ab Rahman AF

Complement Ther Clin Pract, 2018 May;31:53-56.
PMID: 29705480 DOI: 10.1016/j.ctcp.2018.01.016

OBJECTIVE: Traditional and Complementary Medicines (TCM) are widely used worldwide, and many of them have the potential to cause toxicity, interaction with conventional medications and non-adherence to prescribed medications due to patients' preference for the TCM use. However, information regarding their use among patients seeking care at emergency departments (ED) of a healthcare facility is limited. The study aimed to evaluate the TCM use among patients attending the ED of a teaching hospital in Malaysia.
STUDY DESIGN: A sub-analysis of data from a prevalence study of medication-related visits among patients at the ED of Hospital Universiti Sains Malaysia was conducted. The study took place over a period of six weeks from December 2014 to January 2015 involving 434 eligible patients. Data on demography, conventional medication, and TCM uses were collected from patient interview and the medical folders.
RESULTS: Among this cohort, 66 patients (15.2%, 95%CI 12.0, 19.0) reported concurrent TCM use. Sixteen (24.2%) of the TCM users were using more than one (1) type of TCM, and 17 (25.8%) came to the ED for medication-related reasons. Traditional Malay Medicine (TMM) was the most frequently used TCM by the patients. Five patients (7.6%) sought treatment at the ED for medical problems related to use of TCM.
CONCLUSION: Patients seeking medical care at the ED may be currently using TCM. ED-physicians should be aware of these therapies and should always ask patients about the TCM use.
Fulltext Prevalence and characteristics of medication errors at an emergency department of a teaching hospital in Malaysia

Shitu Z, Aung MMT, Tuan Kamauzaman TH, Ab Rahman AF

BMC Health Serv Res, 2020 Jan 22;20(1):56.
PMID: 31969138 DOI: 10.1186/s12913-020-4921-4

BACKGROUND: Medication use process in the emergency department (ED) can be challenging and the risk for medication error (ME) to occur is high. In Malaysia, several studies on ME have been conducted in various hospital settings. However, little is known about the prevalence of ME in emergency department (ED) in these hospitals. The objective of this study was to determine the prevalence and characteristics of ME at an ED of a teaching hospital in Malaysia.
METHODS: A cross-sectional study was conducted over the period of 9 weeks in patients who visited the ED of Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia. Data on patient medication orders and demographic information was collected from the doctor's clerking sheet. Observations were made on nursing activities and these were documented in the data collection form. Other information related to the administration of medications were obtained from the nursing care records.
RESULTS: Observations and data collections were made for 547 patients who fulfilled the study criteria. From these, 311 patient data were randomly selected for analysis. Ninety-five patients had at least one ME. The prevalence of ME was calculated to be 30.5%. The most common types of ME were wrong time error (46.9%), unauthorized drug error (25.4%), omission error (18.5%) and dose error (9.2%). The most frequently drug associated with ME was analgesics. No adverse event was observed.
CONCLUSIONS: The prevalence of ME in our ED setting was moderately high. However, the majority of them did not result in any adverse event. Intervention measures are needed to prevent further occurrence.
The feasibility and acceptability of hypnotherapy among overweight and obese individuals in a Malaysia's public university

Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F, Lua PL

J Complement Integr Med, 2021 Apr 02;18(3):561-568.
PMID: 33794082 DOI: 10.1515/jcim-2020-0177

OBJECTIVES: The global epidemic of overweight and obesity presents a major challenge in the health status of the society. Their prevalence is at an alarming rate worldwide due to poor compliance with conventional treatment and high rates of relapse, thus increasing demand for an effective and safe alternative approach such as hypnotherapy. This study aimed to evaluate the feasibility and acceptability of hypnotherapy for weight loss and to compare these among selected socio-demographics.
METHODS: A cross-sectional study was conducted among 30 students and staff of a public university in Terengganu, Malaysia using convenience sampling. Data analysis was carried out using SPSS 23.0.
RESULTS: Among the respondents (age = 26.17 ± 8.23 years; female = 66.7%; students = 63.3%), 40.0% were overweight and 60.0% were obese. Results indicated excellent feasibility as determined by participants' satisfaction towards the clarity of hypnotherapist's voice (93.3%), the suitability of content (86.7%) and time spent for the session (90.0%). Good overall acceptability (>60.0%) was also reported regarding hypnotherapist professionalism, the environment and perceived usefulness of hypnotherapy. Obese individuals were significantly more satisfied towards the hypnotherapist environment than overweight respondents (p=0.015). Additionally, no adverse effects were reported after the intervention.
CONCLUSIONS: This evidence signalled that hypnotherapy is a promising alternative tool in assisting overweight and obese individuals to lose weight. Extensive research is needed to substantiate its role in weight management programs for its full benefits.
Fulltext Complementary and Alternative Therapies for Weight Loss: A Narrative Review

Lua PL, Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F

J Evid Based Integr Med, 2021 9 10;26:2515690X211043738.
PMID: 34496677 DOI: 10.1177/2515690X211043738

Despite various strategies, overweight and obesity problems are still increasingly prevalent worldwide with serious health outcomes. Consequently, the continuous demand for more effective, safe and acceptable therapies for reducing body weight is also escalating-including complementary and alternative therapies (CATs). The aim of this review is to provide a summary of the most commonly- and recently-used CATs, with evaluation of their safety and efficacy for weight loss. Electronic scientific databases such as Scopus, PubMed and EBSCO Host were explored for articles that reported CATs for overweight and obesity treatment from 2015 to December 2019. Only systematic reviews, meta-analysis and randomized controlled trials (RCTs) published in English were included. Studies whereby CATs were not utilized for reducing body weight were excluded. Eight systematic reviews and meta-analyses and 11 additional RCTs with 765 participants (50.2% overweight and 49.8% obese) related to hypnotherapy, acupuncture and dietary supplements met the inclusion criteria. Their results suggested that spirulina, chitosan, probiotic, EPA + DHA, vitamin D, fiber, and herbal extract supplementation may all provide small reductions in body weight (ranging from 1-10 kg). Interestingly, hypnotherapy and acupuncture reported significantly greater reduction in body weight compared with placebo (p < 0.001 and p < 0.0001, respectively). Nonetheless, the evidence is still relatively limited and not encouraging to provide a definitive conclusion due to the methodological shortcomings and the presence of adverse events in chitosan and fiber supplementation. Hence, studies of this nature need to be further replicated and improved to corroborate the efficacy and safety of the CATs to combat weight issues.
Does hypnosis result in greater weight loss compared to conventional approach?

Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F, Shahril MR, et al.

Am J Clin Hypn, 2022 Feb 02.
PMID: 35108492 DOI: 10.1080/00029157.2021.2010642

Hypnosis has been increasingly used in recent years as an alternative treatment to maintain well-being. Yet, limited evidence is available regarding its role in weight management, especially in Malaysia. Hence, this quasi-experimental study was conducted to evaluate the 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 covariance (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.
Fulltext Mobile Technology in Medicine: Development and Validation of an Adapted System Usability Scale (SUS) Questionnaire and Modified Technology Acceptance Model (TAM) to Evaluate User Experience and Acceptability of a Mobile Application in MRI Safety Screening

Cheah WH, Mat Jusoh N, Aung MMT, Ab Ghani A, Mohd Amin Rebuan H

Indian J Radiol Imaging, 2023 Jan;33(1):36-45.
PMID: 36855734 DOI: 10.1055/s-0042-1758198

Background Magnetic resonance imaging (MRI) safety screening is a crucial procedure for patient preparation before entering into MRI room. Many hospitals in Malaysia are still using the MRI safety checklist printed form. Besides, clinicians will not get a definite conclusion about whether the patient is contraindicated for MRI or not. Hence, we have created one mobile application named MagnetoSafe to overcome this issue. The application will provide an instant decision on whether the patient has no contraindication, relative contraindication, or absolute contraindicated for MRI. We need to check for acceptability and user experience for any newly created mobile application. Objective This study was designed to check the validity of the adapted Technology Acceptance Model (TAM) and System Usability Scale (SUS) Questionnaire. Method The validity and reliability of the questionnaire were investigated. Subsequently, 52 fully completed responses were collected. Results Face and content validity of the questionnaires are considered acceptable with only minor changes to Item 10 of SUS. The Cronbach's alpha for the SUS questionnaire (10 questions) is -0.49, which is not acceptable. The Cronbach's alpha for TAM questionnaire (3 domains; 14 questions) is acceptable, which is 0.910 for perceived usefulness, 0.843 for perceived ease of use, and 0.915 for intention to use. Conclusion Face validity of the adapted SUS and modified TAM questionnaires is acceptable with only minor changes to Item 10 in SUS. Content validity with experts is good. However, the reliability of the SUS questionnaire is not acceptable and therefore adapted SUS will not be used for assessing user experience. The reliability of the modified TAM questionnaire with the original three-factor structure is considered acceptable and can be used to evaluate the user's acceptability of MagnetoSafe.
A Qualitative Exploration of Weight Loss Experiences through Hypnotherapy

Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F, Lua PL

Int J Clin Exp Hypn, 2023;71(3):235-249.
PMID: 37378644 DOI: 10.1080/00207144.2023.2227237

Hypnotherapy has been gaining recognition as an alternative treatment for excess weight problems. This qualitative study aims to explore individuals' experiences of losing weight through hypnotherapy and their perceived barriers and facilitators for healthy lifestyle changes. Semistructured interviews were conducted with 15 participants (11 women and 4 men; mean age of 23 years) who recorded having lost ≥5% weight after undergoing 3 hypnotherapy sessions previously at a public university in Terengganu, Malaysia. Each interview was audiotaped, transcribed, and analyzed using thematic analysis. The themes that emerged were the usefulness of hypnotherapy, barriers, and facilitators of healthy lifestyle changes. All participants contended that hypnotherapy played a role in their weight-loss journey through increased mindful eating and enhanced motivation to make lifestyle modifications. Barriers to healthy lifestyle changes included high costs of healthy foods and lack of support for healthy food sources in social and family settings. Hypnotherapy is essential as an adjunct tool in assisting weight loss. However, additional efforts are needed to improve support in the weight management journey.