Accessible Requires Authentication Published by De Gruyter November 11, 2020

Women’s use and acceptability of guided imagery in a multi-behavior intervention focused on psychological stress, food cravings, and exercise

Peter Giacobbi ORCID logo, Kylie Phillips, Samantha Shawley, Richard Nolan, Kelsey Johnson and Ranjita Misra



The purpose of this short report was to describe the experiences of 29 overweight or obese women (Mage = 44) who completed a multi-behavior guided imagery intervention that simultaneously targeted psychological stress, food cravings, and physical activity behavior.


Participants created tailored guided imagery scripts with health coaches for daily use as part of the 5 week randomized controlled wait-list trial. Post-intervention semi-structured interviews were transcribed verbatim and content analyzed for common conceptual themes.


The results showed that 83% of the participants stated they would continue using guided imagery, <7% would not, while the remaining 10% were unsure about future usage. The perceived usefulness varied across the three behaviors.


Guided imagery has the potential to simultaneously address multiple health behaviors. Our results shed light on how tailored guided imagery scripts can be used to help overweight and obese women manage or lose body weight.

Corresponding author: Peter Giacobbi, Jr, Department of Sport Sciences, Joint Appointment in Department of Social and Behavioral Health Sciences, West Virginia University, PO Box 6116, Health & Education Building, Morgantown, WV 26506-6116, USA, Phone: +1 304 293 5970, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.


America’s Health Rankings. (2019). United Health Foundation: America’s Health Rankings. Retrieved from [Accessed on 22 July 2020]. Search in 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. Search in Google Scholar

Clarke, T. C., Black, L. I., Stussman, B. J., Barnes, P. M., & Nahin, R. L. (2015). Trends in the use of complementary health approaches among adults: United States, 2002–2012. National health statistics reports, (79), 1–16. Retrieved from Search in Google Scholar

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

Giacobbi, P. R.Jr., Buman, M. P., Dzierzewski, J., Aiken-Morgan, A. T., Roberts, B., Marsiske, M., … Smith-McCrae, C. (2014). Content and perceived utility of mental imagery by older adults in a peer-delivered physical activity intervention. Journal of Applied Sport Psychology, 26(2), 129–143. Search in Google Scholar

Giacobbi, P., Long, D., Nolan, R., Shawley, S., Johnson, K., & Misra, R. (2018). Guided imagery targeting exercise, food cravings, and stress: A multi-modal randomized feasibility trial. Journal of Behavioral Medicine, 41(1), 87–98. Search in Google Scholar

Hall, C. R., Mack, D., Paivio, A., & Hausenblas, H. A. (1998). Imagery use by athletes. Development of the sport imagery questionnaire. International Journal of Sport Psychology, 29, 73–89. Search in Google Scholar

Kemps, E., & Tiggemann, M. (2014). A role for mental imagery in the experience and reduction of food cravings. Frontiers in Psychiatry, 5, 193. Search in Google Scholar

Morewedge, C. K., Huh, Y. E., & Vosgerau, J. (2010). Thought for food: Imagined consumption reduces actual consumption. Science, 330(6010), 1530–1533. Search in 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 & Complementary Medicine, 17(2), 117–125. Search in Google Scholar

Potenza, M. N., & Grilo, C. (2014). How relevant is food craving to obesity and its treatment? Frontiers in Psychiatry, 5, 164. Search in Google Scholar

Received: 2020-09-16
Accepted: 2020-10-16
Published Online: 2020-11-11

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