Comparing the effectiveness of dialectical behavior therapy and mindfulness-based cognitive therapy on fear of negative evaluation in obese patients

Saeedi Asl, Sahar; Moraveji, Mahtab; Moallem, Maesoomeh; Hobbi, Mohammad bagher; Manzari Tavakoli, Vahid

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Comparing the effectiveness of dialectical behavior therapy and mindfulness-based cognitive therapy on fear of negative evaluation in obese patients

Sahar Saeedi Asl

, Mahtab Moraveji ^*

, Maesoomeh Moallem

, Mohammad bagher Hobbi

, Vahid Manzari Tavakoli

Department of Nursing and Midwifery, Za.C., Islamic Azad University, Zanjan, Iran , @iau.ac.ir

Abstract: (454 Views)

Abstract
Background and Objective: Obesity has become a global epidemic and attention to its components and variables are very important to study. The present study was conducted by comparing the effectiveness of dialectical behavior therapy and mindfulness-based cognitive therapy on fear of negative evaluation in obese patients.
Methods: In this study, a quasi-experimental pre-test-post-test-follow-up design with a control group was used. The statistical population included obese patients referring to Tehran medical centers in 2024. Using purposive sampling, 45 people were selected and randomly assigned to three groups (15 people): "Experiment 1 (recipients of dialectical behavior therapy)", "Experiment 2 (recipients of mindfulness-based cognitive therapy)" and "control". The research instrument included the Fear of Negative Evaluation Scale (BFNES). The data were analyzed using mixed variance analysis and Bonferroni post hoc test in SPSS-26 software.
Results: Both dialectical behavior therapy and mindfulness-based cognitive therapy treatment packages significantly reduced fear of negative evaluation in the post-test and follow-up stages compared to the control group, and their effects were stable (p<0.001). In the variable of fear of negative evaluation, dialectical behavior therapy showed significantly greater effectiveness than mindfulness-based cognitive therapy (p<0.05).
Conclusion: In general, both treatment packages were effective, but dialectical behavior therapy showed relative superiority in fear of negative evaluation. These findings can be used in designing psychological interventions for patients with obesity.
Keywords: dialectical behavior therapy, mindfulness-based cognitive therapy, obesity, fear of negative evaluation.

Keywords: dialectical behavior therapy, mindfulness-based cognitive therapy, obesity, fear of negative evaluation.

Type of Study: Research | Subject: General
Received: 2025/12/13 | Revised: 2026/06/16 | Accepted: 2026/05/20

References

1. World Obesity Federation. World Obesity Atlas 2025.

2. Noroozi E, Dehghani A, Nokani M, Haghayegh SA. Predictors of Quality of Life based-on Coping Strategies and Spiritual Health among Pregnant Women with Obesity. Community Health (Tehran). 2021; 8(2):264-7.

3. Lingvay I, Cohen RV, Roux CWL, Sumithran P. Obesity in adults. Lancet. 2024; 404:972-987. doi:10.1016/S0140-6736(24)01210-8 PMid:39159652

4. Frühbeck G, Busetto L, Dicker D, Yumuk V, Goossens GH, Hebebrand J, et al. The ABCD of obesity: an EASO position statement on a diagnostic term with clinical and scientific implications. Obes Facts. 2019; 12:131-136. doi:10.1159/000497124 PMid:30844811 PMCid:PMC6547280

5. Hall KD, Farooqi IS, Friedman JM, Klein S, Loos RJF, et al. The energy balance model of obesity: beyond calories in, calories out. Am J Clin Nutr. 2022; 115:1243-1254. doi:10.1093/ajcn/nqac031 PMid:35134825 PMCid:PMC9071483

6. Tang C, Zhang X, Zhou C, Li K, Cai Y. The effects of weight self-stigma on psychological distress in adolescents: the chain-mediated roles of fear of negative appearance evaluation and social appearance anxiety. Front Psychol. 2025; 16:1619694. doi:10.3389/fpsyg.2025.1619694 PMid:41050820 PMCid:PMC12488458

7. Gariepy G, Nitka D, Schmitz N. The association between obesity and anxiety disorders in the population: a systematic review and meta-analysis. Int J Obes. 2010; 34:407-419. doi:10.1038/ijo.2009.252 PMid:19997072

8. Almenara CA, Aimé A, Maïano C, Ejova A, Guèvremont G, et al. Weight stigmatization and disordered eating in obese women: the mediating effects of self-esteem and fear of negative appearance evaluation. Eur Rev Appl Psychol. doi:10.1016/j.erap.2017.02.004

9. Yue Y, Wang X. Self-efficacy and negative silence in the classroom: The mediating role of fear of negative evaluation. Nurse Educ Pract. 2022; 62: 103379. doi:10.1016/j.nepr.2022.103379 PMid:35738157

10. Li S, Fu W, Liu W, Zhong N. A Study on the Effect of Fear of Negative Evaluation on Restrained Eating and it's Intervention among Female College Students. Int J Ment Health Promot. 2025; 27(2): 127-139. doi:10.32604/ijmhp.2025.059866

11. Feng W, Zhang MY, Bu YB, Wang CL. Fear of negative evaluation mediates and core self-evaluation moderates the relationship between social comparison orientation and social network addiction. Sci Rep. 2025; 15(1):41417. doi:10.1038/s41598-025-25327-3 PMid:41271885 PMCid:PMC12639156

12. McGowan B, Ciudin A, Baker JL, Halford JCG, Kahan S, et al. A systematic review and meta-analysis of the efficacy and safety of pharmacological treatments for obesity in adults. Nat Med. 2025; 31:3317-3329. doi:10.1038/s41591-025-03978-z PMid:41039116 PMCid:PMC12532627

13. Aoun A, Ghoussoub C, Farsoun C, Al Mallah A, Ayoub F, et al. Examining the efficacy of mindfulness-based interventions in treating obesity, obesity-related eating disorders, and diabetes mellitus. J Am Nutr Assoc. 2025; 44(4):292-305. doi:10.1080/27697061.2024.2428290 PMid:39556797

14. Torres LC, Pereira T, Pinheiro P, Lima V, de Luna G. Mindfulness as Adjuvant Treatment for Obsessive‐Compulsive Disorder: An Integrative Review. Rev Port Psiquiatr Saude Ment. 2023; 9(2): 58-65. doi:10.51338/rppsm.290

15. Gorji S. Comparing the effectiveness of occupational stress training package with mindfulness-based cognitive therapy on job burnout of Tam Kar's employees in order to health promotion. J Educ Health Promot. 2025; 14(1): 58. doi:10.4103/jehp.jehp_1675_23

16. Sun Y, Wang J, Mao F, Sun J, Zhang X, Cao F. Personalized exploration of mindfulness-based intervention on antenatal depression: Moderated mediation analyses of a randomized controlled trial. Curr Psychol. 2023; 42(26):22217-22225. doi:10.1007/s12144-022-03231-7

17. Hooker AR, Sagui-Henson SJ, Daubenmier J, Moran PJ, Hartogensis W, et al. Effects of a mindfulness-based weight loss intervention on long-term psychological well-being among adults with obesity: Secondary analyses from the Supporting Health by Integrating Nutrition and Exercise (SHINE) Trial. Mindfulness. 2022; 13(9):2227-2242. doi:10.1007/s12671-022-01951-2 PMid:36425257 PMCid:PMC9681158

18. Vuong V, Rao V, Ee C. Mindfulness-based interventions and yoga for managing obesity/overweight after breast cancer: a scoping review. Integr Cancer Ther.2022; 21.

19. Toori F, Mahdian H, Bakhshipour A. Comparison of the Effectiveness of Dialectical Behavior Therapy and Meichenbaum-Based Cognitive Therapy on Fear of Negative Evaluation in Students with Social Anxiety Disorder. Iran J Neurodev Disord. 2025; 4(1):111-117.

20. Shamsudeen S, Kannekanti P. Dialectical behaviour therapy enhanced habit reversal training: A clinical case of childhood-onset trichotillomania in an adult with impulsive personality features. Clin Case Stud. 2023; 22(5):468-483. doi:10.1177/15346501231189552

21. Nozari Kohneh Shahri G, Mahdavi Mehr A, Savabi Niri V, Bagheri Sheykhangafshe F, Farahani H. Effectiveness of Group Dialectical Behavior Therapy on Self-doubt, Thought Fusion and Depression in Women with Obsessive-compulsive Disorder. Caspian J Health Res. 2025; 10(2):101-110.

22. Malas O, Gómez-Domenech A. Effect of dialectical behavior therapy on negative affect, and symptoms of depression and anxiety in individuals with borderline personality disorder during COVID-19 pandemic. J Clin Med. 2024; 13(9):2603. doi:10.3390/jcm13092603 PMid:38731131 PMCid:PMC11084774

23. Lammers MW, Vroling MS, Crosby RD, Mares SH, Hutschemaekers GJ, Van Strien. Dialectical Behavior Therapy and Cognitive Behavior Therapy in Individuals With Binge‐Eating Disorder: What Works for Whom? Int J Eat Disord. 2026;59(3):534-545. doi:10.1111/eat.70000. PMid:41272931 PMCid:PMC12979962

24. Aghaei F, Abbasi G, Hasanzadeh R. The effectiveness of cognitive processing therapy on rumination and fear of negative evaluation of betrayed women. J Psychol Sci. 2024; 23(136):109-125.

25. Saeidiasl S, Moraveji M, Moallem M, Tavakoli VM. Development of a Mindfulness-Based Cognitive Therapy Intervention Package for Patients with Obesity. Ment Health Lifestyle J. 2025;1-6. doi:10.61838/mhlj.139

26. Braden A, O'Brien W. Pilot study of a treatment using dialectical behavioral therapy skills for adults with overweight/obesity and emotional eating. J Contemp Psychother. 2021; 51(1):21-29. doi:10.1007/s10879-020-09477-1

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