Skip to main content
SpringerLink
Log in

Guided imagery targeting exercise, food cravings, and stress: a multi-modal randomized feasibility trial

Journal of Behavioral Medicine Aims and scope Submit manuscript

Cite this article

Abstract

The purpose of this randomized wait-list controlled trial was to test the feasibility and preliminary efficacy of a guided imagery based multi-behavior intervention intended to address psychological stress, food cravings, and physical activity. Personalized guided imagery scripts were created and participants were instructed to practice guided imagery every day for 35 consecutive days. Of 48 women who enrolled, we report comparisons between 16 randomized to treatment with 19 who were wait-listed (overall Mage = 45.50; Mbodymassindex = 31.43). Study completers reported 89% compliance with practicing guided imagery during the intervention. A significant time-by-group interaction was observed with reductions in food cravings and increases in physical activity compared with wait-list controls. Telephone-based multi-behavior interventions that utilize guided imagery to address food cravings and exercise behavior appear to be acceptable for overweight and obese women. Future phone-based guided imagery research testing this skill to address multiple health behaviors is justified.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Abildso, C. G., Zizzi, S., & Fitzpatrick, S. J. (2013). Predictors of clinically significant weight loss and participant retention in an insurance-sponsored community-based weight management program. Health Promot Pract, 14(4), 580–588. doi:10.1177/1524839912462393

    Article  PubMed  Google Scholar 

  • Alberts, H. J. E. M., Thewissen, R., & Raes, L. (2012). Dealing with problematic eating behaviour. The effects of a mindfulness-based intervention on eating behaviour, food cravings, dichotomous thinking and body image concern. Appetite, 58(3), 847–851. doi:10.1016/j.appet.2012.01.009

    Article  CAS  PubMed  Google Scholar 

  • Andersson, E. K., & Moss, T. P. (2011). Imagery and implementation intention: A randomised controlled trial of interventions to increase exercise behaviour in the general population. Psychology of Sport and Exercise, 12, 63–70. doi:10.1016/j.psychsport.2010.07.004

    Article  Google Scholar 

  • Andrade, J., Pears, S., May, J., & Kavanagh, D. J. (2012). Use of a clay modeling task to reduce chocolate craving. Appetite, 58(3), 955–963. doi:10.1016/j.appet.2012.02.044

    Article  PubMed  Google Scholar 

  • Bhutani, G. E. (2015). Looking after me looking after you: Using positive cognitive behavioural techniques to improve emotional well-being. The Cognitive Behaviour Therapist. doi:10.1017/S1754470X15000227

    Google Scholar 

  • Bigham, E., McDannel, L., Luciano, I., & Salgado-Lopez, G. (2014). Effect of a brief guided imagery on stress. Biofeedback, 42(1), 28–35. doi:10.5298/1081-5937-42.1.07

    Article  Google Scholar 

  • Bishop, F. L., Yardley, L., & Lewith, G. T. (2007). A systematic review of beliefs involved in the use of complementary and alternative medicine. Journal of Health Psychology, 12(6), 851–867. doi:10.1177/1359105307082447

    Article  PubMed  Google Scholar 

  • Buman, M. P., Giacobbi, P. R., Jr., Dzierzewski, J. M., Aiken Morgan A., McCrae, C. S., Roberts, B. L., et al. (2011). Peer volunteers improve long-term maintenance of physical activity with older adults: A randomized controlled trial. Journal of Physical Activity Health, 8(Suppl 2), S257–S266.

    Article  Google Scholar 

  • Casement, M. D., & Swanson, L. M. (2012). A meta-analysis of imagery rehearsal for post-trauma nightmares: Effects on nightmare frequency, sleep quality, and posttraumatic stress. Clinical Psychology Review, 32(6), 566–574. doi:10.1016/j.cpr.2012.06.002

    Article  PubMed  PubMed Central  Google Scholar 

  • Chan, C. K., & Cameron, L. D. (2012). Promoting physical activity with goal-oriented mental imagery: A randomized controlled trial. Journal of Behavioral Medicine, 35(3), 347–363. doi:10.1007/s10865-011-9360-6

    Article  PubMed  Google Scholar 

  • Chao, A., Grilo, C. M., White, M. A., & Sinha, R. (2015). Food cravings mediate the relationship between chronic stress and body mass index. Journal of Health Psychology, 20(6), 721–729. doi:10.1177/1359105315573448

    Article  PubMed  Google Scholar 

  • Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 386–398.

    Article  Google Scholar 

  • Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. Berlin: Springer.

    Book  Google Scholar 

  • Duncan, L. R., Hall, C. R., Wilson, P. M., & Rodgers, W. M. (2012). The use of a mental imagery intervention to enhance integrated regulation for exercise among women commencing an exercise program. Motivation and Emotion, 36(4), 452–464. doi:10.1007/s11031-011-9271-4

    Article  Google Scholar 

  • Emmons, K. M., McBride, C. M., Puleo, E., Pollak, K. I., Clipp, E., Kuntz, K., et al. (2005). Project PREVENT: A randomized trial to reduce multiple behavioral risk factors for colon cancer. Cancer Epidemiology, Biomarkers & Prevention, 14(6), 1453–1459. doi:10.1158/1055-9965.epi-04-0620

    Article  Google Scholar 

  • Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., & Dietz, W. (2009). Annual medical spending attributable to obesity: Payer-and service-specific estimates. Health Affairs (Millwood), 28(5), w822–w831. doi:10.1377/hlthaff.28.5.w822

    Article  Google Scholar 

  • Flegal, K. M., Carroll, M. D., Kit, B. K., & Ogden, C. L. (2012). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA, 307(5), 491–497. doi:10.1001/jama.2012.39

    Article  PubMed  Google Scholar 

  • Furnham, A., Vincent, C., & Wood, R. (1995). The health beliefs and behaviors of three groups of complementary medicine and a general practice group of patients. Journal of Alternative and Complementary Medicine, 1, 347–359. doi:10.1089/acm.1995.1.347

    Article  CAS  PubMed  Google Scholar 

  • Geller, K., Lippke, S., & Nigg, C. R. (2016). Future directions of multiple behavior change research. Journal of Behavioral Medicine. doi:10.1007/s10865-016-9809-8

    PubMed  Google Scholar 

  • Giacobbi, P. R., Jr., Buman, M. P., Dzierzewski, J., Aiken-Morgan, A. T., Roberts, B., Marsiske, M., et al. (2014a). Content and perceived utility of mental imagery by older adults in a peer-delivered physical activity intervention. J Appl Sport Psychol, 26(2), 129–143. doi:10.1080/10413200.2013.803502

    Article  PubMed  Google Scholar 

  • Giacobbi, P. R., Jr., Dreisbach, K. A., Thurlow, N. M., Anand, P., & Garcia, F. (2014b). Mental imagery increases self-determined motivation to exercise with university enrolled women: A randomized controlled trial. Psychology of Sport and Exercise, 15, 374–381. doi:10.1016/j.psychsport.2014.03.004

    Article  Google Scholar 

  • Giacobbi, P. R., Jr., Stabler, M. E., Stewart, J., Jaeschke, A.-M., Siebert, J., & Kelley, G. (2015). Guided imagery for arthritis and other rheumatic diseases: A systematic review of randomized controlled trials. Pain Mangement Nursing, 16(5), 792–803. doi:10.1016/j.pmn.2015.01.003

    Article  Google Scholar 

  • Godin, G., & Shephard, R. J. (1985). A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sport Science, 10, 141–146.

    CAS  Google Scholar 

  • Goode, A. D., Reeves, M. M., & Eakin, E. G. (2012). Telephone-delivered interventions for physical activity and dietary behavior change: An updated systematic review. American Journal of Preventive Medicine, 42(1), 81–88. doi:10.1016/j.amepre.2011.08.025

    Article  PubMed  Google Scholar 

  • Hawkes, A. L., Chambers, S. K., Pakenham, K. I., Patrao, T. A., Baade, P. D., Lynch, B. M., et al. (2013). Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: A randomized controlled trial. Journal of Clinical Oncology, 31(18), 2313–2321. doi:10.1200/jco.2012.45.5873

    Article  PubMed  Google Scholar 

  • Hawkes, A. L., Patrao, T. A., Green, A., & Aitken, J. F. (2012). CanPrevent: A telephone-delivered intervention to reduce multiple behavioural risk factors for colorectal cancer. BMC Cancer, 12, 560. doi:10.1186/1471-2407-12-560

    Article  PubMed  PubMed Central  Google Scholar 

  • Holmes, E. A., Arntz, A., & Smucker, M. R. (2007). Imagery rescripting in cognitive behaviour therapy: Images, treatment techniques and outcomes. Journal of Behavior Therapy and Experimental Psychiatry, 38(4), 297–305. doi:10.1016/j.jbtep.2007.10.007

    Article  PubMed  Google Scholar 

  • Jacobs, D. R., Ainsworth, B. E., Hartman, T. J., & Leon, A. S. (1993). A simultaneous evaluation of 10 commonly used physical-activity questionnaires. Medicine and Science in Sports and Exercise, 25(1), 81–91. doi:10.1249/00005768-199301000-00012

    Article  PubMed  Google Scholar 

  • Kemps, E., & Tiggemann, M. (2007). Modality-specific imagery reduces cravings for food: An application of the elaborated intrusion theory of desire to food craving. Journal of Experimental Psychology Applied, 13(2), 95–104. doi:10.1037/1076-898x.13.2.95

    Article  PubMed  Google Scholar 

  • Kemps, E., & Tiggemann, M. (2014). A role for mental imagery in the experience and reduction of food cravings. Frontiers in Psychiatry. doi:10.3389/fpsyt.2014.00193

    PubMed  Google Scholar 

  • Knauper, B., McCollam, A., Rosen-Brown, A., Lacaille, J., Kelso, E., & Roseman, M. (2011). Fruitful plans: Adding targeted mental imagery to implementation intentions increases fruit consumption. Psychology and Health, 26(5), 601–617. doi:10.1080/08870441003703218

    Article  PubMed  Google Scholar 

  • Li, F. (1999). The exercise motivation scale: Its multifaceted structure and construct validity. Journal of Applied Sport Psychology, 11, 97–115. doi:10.1080/10413209908402953

    Article  CAS  Google Scholar 

  • Mason, A. E., Epel, E. S., Aschbacher, K., Lustig, R. H., Acree, M., Kristeller, J., et al. (2016). Reduced reward-driven eating accounts for the impact of a mindfulness-based diet and exercise intervention on weight loss: Data from the SHINE randomized controlled trial. Appetite, 100, 86–93. doi:10.1016/j.appet.2016.02.009

    Article  PubMed  PubMed Central  Google Scholar 

  • May, J., Andrade, J., Kavanagh, D., & Penfound, L. (2008). Imagery and strength of craving for eating, drinking, and playing sport. Cognition and Emotion, 22(4), 633–650. doi:10.1080/02699930701446296

    Article  Google Scholar 

  • Mc Sharry, J., Olander, E. K., & French, D. P. (2015). Do single and multiple behavior change interventions contain different behavior change techniques? A comparison of interventions targeting physical activity in obese populations. Health Psychology, 34(9), 960–965. doi:10.1037/hea0000185

    Article  PubMed  Google Scholar 

  • McClelland, A., Kemps, E., & Tiggemann, M. (2006). Reduction of vividness and associated craving in personalized food imagery. Journal of Clinical Psychology, 62(3), 355–365. doi:10.1002/jclp.20216

    Article  PubMed  Google Scholar 

  • Missbach, B., Florack, A., Weissmann, L., & König, J. (2014). Mental imagery interventions reduce subsequent food intake only when self-regulatory resources are available. Frontiers in Psychology. doi:10.3389/fpsyg.2014.01391

    PubMed  PubMed Central  Google Scholar 

  • Morewedge, C. K., Huh, Y. E., & Vosgerau, J. (2010). Thought for food: Imagined consumption reduces actual consumption. Science, 330(6010), 1530–1533. doi:10.1126/science.1195701

    Article  CAS  PubMed  Google Scholar 

  • Nichol, J., Thompson, E. A., & Shaw, A. (2011). Beliefs, decision-making, and dialog about complementary and alternative medicine (CAM) within families using CAM: A qualitative study. Journal of Alternative and Complementary Medicine, 17(2), 117–125. doi:10.1089/acm.2010.0171

    Article  PubMed  Google Scholar 

  • Nijs, I. M. T., Franken, I. H. A., & Muris, P. (2007). The modified trait and state food-cravings questionnaires: Development and validation of a general index of food craving. Appetite, 49(1), 38–46. doi:10.1016/j.appet.2006.11.001

    Article  PubMed  Google Scholar 

  • Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among us children and adolescents, 1999-2010. JAMA, 307(5), 483–490. doi:10.1001/jama.2012.40

    Article  PubMed  Google Scholar 

  • Potenza, M. N., & Grilo, C. (2014). How relevant is food craving to obesity and its treatment? Frontiers in Psychiatry. doi:10.3389/fpsyt.2014.00164

    PubMed  PubMed Central  Google Scholar 

  • Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78. doi:10.1037/0003-066X.55.1.68

    Article  CAS  PubMed  Google Scholar 

  • Ryan, R. M., Patrick, H., Deci, E. L., & Williams, G. C. (2008). Facilitating behavior change and its maintenance: Interventions based on self-determination theory. The European Health Psychologist, 10, 2–5.

    Google Scholar 

  • Schiller, J. S., Lucas, J. W., Ward, B. W., & Peregoy, J. A. (2012). Summary health statistics for U.S. adults: National Health Interview Survey, 2010. Vital Health Statistics, 10(252).

  • Silva, M. N., Vieira, P. N., Coutinho, S. R., Minderico, C. S., Matos, M. G., Sardinha, L. B., et al. (2010). Using self-determination theory to promote physical activity and weight control: A randomized controlled trial in women. Journal of Behavioral Medicine, 33, 110–122. doi:10.1007/s10865-009-9239

    Article  PubMed  Google Scholar 

  • Skorka-Brown, J., Andrade, J., & May, J. (2014). Playing ‘Tetris’ reduces the strength, frequency and vividness of naturally occurring cravings. Appetite, 76, 161–165. doi:10.1016/j.appet.2014.01.073

    Article  PubMed  Google Scholar 

  • Spring, B., Moller, A. C., & Coons, M. J. (2012). Multiple health behaviours: Overview and implications. Journal of Public Health, 34(Suppl 1), i3–i10. doi:10.1093/pubmed/fdr111

    Article  PubMed  PubMed Central  Google Scholar 

  • Stanley, D. M., & Cumming, J. (2010). Are we having fun yet? Testing the effects of imagery use on the affective and enjoyment responses to acute moderate exercise. Psychology of Sport and Exercise, 11, 582–590. doi:10.1016/j.psychsport.2010.06.010

    Article  Google Scholar 

  • Teixeira, P. J., Carraca, E. V., Markland, D., Silva, M. N., & Ryan, R. M. (2012). Exercise, physical activity, and self-determination theory: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 9(78), http://www.ijbnpa.org/content/9/1/78

  • Thomas, N. J. T. (2016). Mental Imagery: The Stanford Encyclopedia of Philosophy. In E. N. Zalta (Ed.), The Stanford Encyclopedia of Philosophy (Summer, 2016 ed.): Center for the Study of Language and Information. Retrieved from http://plato.stanford.edu/archives/sum2016/entries/mental-imagery

  • Tiggemann, M., & Kemps, E. (2005). The phenomenology of food cravings: The role of mental imagery. Appetite, 45(3), 305–313. doi:10.1016/j.appet.2005.06.004

    Article  CAS  PubMed  Google Scholar 

  • US Department of Health and Human Services. (2008). Physical activity guidelines advisory committee report 2008. Retrieved from http://www.health.gov/paguidelines/committeereport.aspx

  • van Berkel, J., Boot, C. R. L., Proper, K. I., Bongers, P. M., & van der Beek, A. J. (2014). Effectiveness of a worksite mindfulness-based multi-component intervention on lifestyle behaviors. The International Journal of Behavioral Nutrition and Physical Activity. doi:10.1186/1479-5868-11-9

    PubMed  PubMed Central  Google Scholar 

  • Vander Wal, J. S., Johnston, K. A., & Dhurandhar, N. V. (2007). Psychometric properties of the State and Trait Food Cravings Questionnaires among overweight and obese persons. Eating Behaviors, 8(2), 211–223. doi:10.1016/j.eatbeh.2006.06.002

    Article  PubMed  Google Scholar 

  • Verkaik, R., Busch, M., Koeneman, T., van den Berg, R., Spreeuwenberg, P., & Francke, A. L. (2014). Guided imagery in people with fibromyalgia: A randomized controlled trial of effects on pain, functional status and self-efficacy. Journal of Health Psychology, 19(5), 678–688. doi:10.1177/1359105313477673

    Article  PubMed  Google Scholar 

  • Wininger, S. R. (2007). Self-determination theory and exercise behavior: An examination of the psychometric properties of the exercise motivation scale. Journal of Applied Sport Psychology, 19, 471–486.

    Article  Google Scholar 

  • World Health Organization. (2010). Global recommendations on physical activity and health. Geneva, Switzerland: World Health Organization.

Download references

Acknowledgements

This publication is a product of the West Virginia Prevention Research Center and was supported by Cooperative Agreement Number 1-U48-DP-005004 from the Centers for Disease Control and Prevention. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

  1. Department of Sport Sciences, Joint Appointment, Social and Behavioral Sciences, West Virginia University, Health and Education Building, 208, 375 Birch Street, P. O. Box 6116, Morgantown, WV, 26506-6116, USA

    Peter Giacobbi Jr.

  2. Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Ryals Public Health Building, Room 327, Birmingham, AL, 35294-0022, USA

    Dustin Long

  3. School of Medicine, West Virginia University, Morgantown, WV, USA

    Richard Nolan & Kelsey Johnson

  4. School of Public Health, West Virginia Univesity, Morgantown, WV, USA

    Samantha Shawley

  5. Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, 3301 HSC South, Morgantown, WV, 26505, USA

    Ranjita Misra

Authors
  1. Peter Giacobbi Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dustin Long
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Richard Nolan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Samantha Shawley
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kelsey Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ranjita Misra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter Giacobbi Jr..

Ethics declarations

Conflict of interest

Authors Peter Giacobbi, Jr., Dustin Long, Richard Nolan, Samantha Shawley, Kelsey Johnson, and Ranjita Misra declare that they have no conflicts of interest.

Human and animal rights and Informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Giacobbi, P., Long, D., Nolan, R. et al. Guided imagery targeting exercise, food cravings, and stress: a multi-modal randomized feasibility trial. J Behav Med 41, 87–98 (2018). https://doi.org/10.1007/s10865-017-9876-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-017-9876-5

Keywords

search

Navigation