hipótesis específica III

Historically, the movement of positive psychology was born as a form of criticism of the research practices within the field of traditional psychology, which focused mainly on relieving suffering basing the discipline largely on a medical model of psychological disorders, but neglecting the positive aspects of human functioning (Ruini, 2017). Although positive psychology as a science is very young, its history and origins are deeply rooted in ancient Greek philosophies and traditional psychological approaches, some of which have been researching the concept of well-being for decades. Given this perspective, one may ask, why is positive psychology needed? In order to answer this question, it is essential to understand the concept of well-being and the ways it has been defined in the past.

All professional practices (e.g. therapy, health care, teaching, parenting, preaching etc.) have always aimed to change humans for the better. The question is, however, what “the better”

truly means. From the historical point of view, psychosocial research on well-being has been dominated by two relatively distinct approaches that were different in their main characteristics, theoretical contributors, and assessment tools: (1) the hedonic or subjective approach to well-being, and (2) the eudaimonic or psychological approach (Ryan & Deci, 2001). Hedonism reflects the view that wellbeing consists of pleasure or happiness and pain avoidance (Kahneman, Diener & Schwarz, 1999). The concept of hedonic well-being could, therefore, be described as the presence of more positive emotions over negative ones, and a general positive evaluation of one’s life condition, in particular, life satisfaction (Diener, Suh, Lucas & Smith, 1999). Eudaimonism, on the other hand, is centred on the premise that well-being consists of more than just happiness. It is the ultimate actualisation of human potential in a process of self-realisation (Waterman, 1993). Eudaimonic theories describe the

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psychological well-being as a multifaceted concept (Huta & Waterman, 2014) emphasizing different personality traits, such as self-esteem, meaning in life, optimism, enjoyment, and autonomy (Ryan & Deci, 2001; Ryff, 1989; Waterman, Schwartz, Zamboanga et al., 2010).

Recently, with the diffusion of the positive psychology movement, there has been an increasing awareness about the fact that positive affect is not the opposite of negative affect (Cacioppo & Berntson 1999), and that well-being is not just the absence of mental illness (Duckworth et al., 2005). The importance of integrating hedonic and eudaimonic approaches, as they complement each other in defining the overall construct of well-being (Ryan & Deci, 2001), has been recognised over the past couple of decades. The concept of optimal human functioning or optimal being has been defined as a combination of high subjective well-being and high psychological well-well-being (Ruini, 2017). In the current society, there seems to be only a very small number of people who would fall under the criteria defined by optimal human functioning, paving the way for possible psychosocial interventions.

There is no doubt that physical health and well-being are related concepts that affect each other – poor physical health has a negative impact on well-being and poor well-being is related to physical illness (McCloughen, Foster, Kerley, Delgado & Turnell, 2016). Sickness is often associated with displeasure or pain, so the presence of illness might directly increase negative affect. Additionally, since illness often presents functional limitations, it can prevent people from noticing opportunities for positive affect and life satisfaction (Ryan & Deci, 2001).

The relationship between obesity and quality of life and mental well-being has been well documented in the past (Wardle & Cooke, 2005). Living with obesity impairs quality of life and increases the risk of psychiatric and affective disorders and vice versa. Patients with psychological troubles may become obese as a medication side effect and/or because they use food as a coping strategy (Avila, Holloway, Hahn et al., 2015; Polivy & Herman, 2005;

Sharma, 2012; Van Der Merwe, 2007). Therefore, targeting well-being in obese populations

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using positive psychology has the potential to directly improve quality of life and indirectly affect health behaviours in those populations.

Additionally, PPIs may help manage distress over obesity, which is thought to be a critical factor in successful long-term weight management (Vallis, 2016). Enhancing their experience of positive emotion, these interventions may help patients with obesity develop better coping strategies regarding their health behaviours, and become more flexible and creative in finding alternative solutions to problems (Tchanturia, Dapelo, Harrison &

Hambrook, 2015). Indeed, PPIs have been successfully applied to a number of comorbidities associated with obesity, including obesity-related eating disorders.

A number of recent reviews indicated that mindfulness-based therapies may be an effective form of treatment for eating disorders and obesity-related eating pathology (Godsey, 2013; Katterman, Kleinman, Hood, Nackers & Corsica., 2014; O'Reilly, Cook, Spruijt-Metz &

Black, 2014), with some researchers even proposing that mindfulness is an essential component of holistic obesity treatment (Douglass, 2011; Kristeller & Wolever, 2011). Mindfulness-based approaches have been found to decrease automatic eating, as well as individuals’ tendency to eat in response to their emotions, which has been considered as one of the main contributors to obesity development and maintenance (Faith, Allison, & Geliebter, 1997). Furthermore, emotional eating underlies many of the negative moods (e. g. depression and anxiety) that have been found to be associated with overeating (Thayer, 2001), and have been effectively treated with PPIs (Sin & Lyubomirsky, 2009). Increasing well-being in individuals with weight problems by reducing distress, negative emotions, depressive moods and anxiety may, in addition, lead to decreases in their maladaptive eating behaviours. This may result in weight loss as a by-product of improved well-being. Therefore, a comprehensive PPI designed for individuals with weight problems could potentially represent an effective holistic approach to obesity treatment.

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2.2. Obesity

The main purpose of this section is to review current treatment approaches used to address adult overweight and obesity. To enable an accurate assessment of individuals participating in the studies conducted within this PhD, different assessment methods were also reviewed. These are provided in Appendix A.