EFFECTS OF COGNITIVE BEHAVIORAL PSYCHOTHERAPY ON BODY COMPOSITION AND CONSTITUTION

摘要

Obesity is a chronic disease of modern times that is not just a cosmetic problem but a bio-social-psychological problem especially, which means that obese individuals have, apart from their medical problems, also social and psychological problems. They often suffer from depression, low self esteem and difficulties in the job market field. The aim of the study was to examine the effect of physical activity and the modification of nutrition patterns on the somatic parameters in STOB courses (the courses for weight loss and obesity reduction) in women at the age of 20-60 years (n = 114). The standardised anthropometrical methods were used to determine the basic somatic indexes -body weight and height, risk indexes and central obesity indexes, body composition according to Parizkova, and Matiegka and bioelectric impedance methods (QuadScan 4000; Tanita BC 418-MA). Women were divided into the groups according to age decennary. Women were measured at the beginning and at the end of the course, which lasted 12 weeks. STOB courses are led by professionals who are involved not only in physical activity but also in modification of nutrition and food intake patterns. In the groups as a whole, the BMI reached the average values of 31.34 in the initial examination, although the maximal value exceeded the limit of morbid obesity, which is 47.56. On the basis of the BMI categorisation by WHO, only 7.5 of women were in the "standard" category and 57 were obese, of which 5 were morbidly obese. According to the evaluation of subcutaneous adipose tissue using Matiegka methodology, 57.5 had more than 30 fat content, of which 28.75 was in the category of over 40 fat. The values of the centrality index, which are the ratio of the individual skin folds on the trunk and on the extremities and it shows the distribution of fat, reached values from 1.3 to 1.5. These values demonstrate the disproportional distribution of fat, with a dominancy of subcutaneous fat on the trunk. The centrality indexes correlate with WHR values and confirmed the distribution of fat was confirmed, particularly on the trunk part in comparison to the lower extremities - thus we are looking at the abdominal type of obesity. When the course had been completed, all methods used confirmed significant changes - lowering of body weight, BMI and the amount of adipose tissue in all age groups. The evaluation of the average values of circumferential dimensions showed a reduction in waist and hip circumference, in abdominal and gluteal circumferences, and eventually in the lower extremities' circumferences. A significant lowering of the endomorphic component was found in all age categories. Movement and exercise therapy in combination with changes of dietary regimes within the framework of STOB body weight reduction courses has a nearly 15 year tradition in the Czech Republic and has had significant effects on its clients' somatic condition.