Efeitos da escuta musical sobre a redução do estresse de indivíduos em tratamento nutricional para excesso de peso

Abstract

Excess weight is currently a global public health problem. Its association with stress has been repeatedly observed in population studies; and its contribution is due to neuroendocrine and behavioral changes resulting from the stress response. The neuroendocrine effects of music on stress allow hypotheses to be raised about an approach to the treatment of excess weight. Thus, this thesis aimed to evaluate the effect of listening to music on stress reduction and its adjuvant efficacy for the nutritional treatment of overweight individuals with self-reported stress. Based on the hypothesis that the group exposed to music would show better outcomes, this study was developed through an integrative review and a research design divided into two randomized controlled clinical trials. In the first trial, the experimental group (n = 28) underwent music listening intervention and was compared to the control group that listened to podcast (n = 26), both in a single 20-minute session. Salivary cortisol levels and subjective perception of stress were assessed. The second trial evaluated the impact of listening to music as an adjunct to nutritional treatment for three months. The experimental group (n = 20) received daily listening to music and nutritional monitoring. The same treatment was offered to the control group (n = 14) who listened to podcasts. In this trial, self-reported stress was assessed using the DASS-21 scale (which also assesses depression and anxiety); perception of treatment was based on qualitative and quantitative analyses, and nutritional results were measured by percentage of weight loss, anthropometric indices, and adherence variables. In experiment 01, the intervention group showed a significant reduction in cortisol after listening (p < 0.01, effect size = 0.85), as did the control group (p = 0.03, effect size = 0.42), which had a smaller size effect for the intervention. Regarding subjective perception, a greater number of relaxation variables were observed in the experimental group. In experiment 02, listening to music generated positive repercussions. After 03 months, the intervention group showed improvement in intra- subject psychometric parameters in stress (p = 0.02), depression (p = 0.01) and anxiety (p < 0.01), while only the stress domain showed a reduction in the control group (p = 0.02). Listening to music generated a higher percentage of weight loss at the end of the treatment in the intervention group (p = 0.02; effect size = 0.40) compared to the control group, with a positive correlation being found between weight loss and frequency of listening to music (r = 0.48, p = 0.04). In addition, the intervention group showed better adherence to the diet in the intermediate time (p = 0.04) and perception of relaxation of the mind according to the analysis of words given in testimonies. Taken together, the findings obtained in this thesis suggest that listening to music has a relevant role as an adjuvant practice in the treatment of obesity. Future studies with greater sample power and in other clinical contexts must be conducted.