Behavioral and Psychological Treatments for Obesity
Behavioral and/or cognitive therapy can be used as part of a program of lifestyle modification with diet and exercise for individuals who do not meet criteria for or do not want bariatric surgery. Classical and operant conditioning are the two traditional behavioral therapy models, usually used in weekly sessions lasting 1-1.5 hours over a six-month period. Participants generally have lost an average of 10% of their initial weight.[8]
In classical conditioning, eating behaviors are associated with other activities. The behaviors become conditioned to occur together, as when a person eats nachos while watching the evening news. If these two behaviors are paired repeatedly, they become so strongly associated with one another that turning on the news alone triggers a craving for nachos. Behavioral intervention involves identifying and extinguishing the inappropriate psychological or environmental triggers and cues.
Operant conditioning uses reinforcement and consequences. A person who uses food as a reward or to temporarily attenuate stress will associate food with a more pleasurable state, which makes it more likely to to become a repeated behavior. Although behavior therapy results in lifestyle changes and weight loss in the short-term, there is no strong evidence of its long-term effectiveness.
More recently cognitive therapy and cognitive behavioral therapy (CBT) have become an important aspect of the treatment of obesity. Cognitions influence both feelings and behaviors, and they cannot be ignored when treating obesity. CBT is utilized in the treatment of obesity as a way to help individuals change their negative eating behaviors and incorporate healthy lifestyle changes.[9] These CBT interventions are self-monitoring techniques (e.g. food and exercise journals), stress management, stimulus control (e.g. eating only at the kitchen table), social support, problem solving, and cognitive restructuring (e.g. helping patients have more realistic weight loss goals, avoidance and challenging of self defeating beliefs).[10]
Behavioral and Psychological Treatments for ObesityBehavioral and/or cognitive therapy can be used as part of a program of lifestyle modification with diet and exercise for individuals who do not meet criteria for or do not want bariatric surgery. Classical and operant conditioning are the two traditional behavioral therapy models, usually used in weekly sessions lasting 1-1.5 hours over a six-month period. Participants generally have lost an average of 10% of their initial weight.[8] In classical conditioning, eating behaviors are associated with other activities. The behaviors become conditioned to occur together, as when a person eats nachos while watching the evening news. If these two behaviors are paired repeatedly, they become so strongly associated with one another that turning on the news alone triggers a craving for nachos. Behavioral intervention involves identifying and extinguishing the inappropriate psychological or environmental triggers and cues.Operant conditioning uses reinforcement and consequences. A person who uses food as a reward or to temporarily attenuate stress will associate food with a more pleasurable state, which makes it more likely to to become a repeated behavior. Although behavior therapy results in lifestyle changes and weight loss in the short-term, there is no strong evidence of its long-term effectiveness.More recently cognitive therapy and cognitive behavioral therapy (CBT) have become an important aspect of the treatment of obesity. Cognitions influence both feelings and behaviors, and they cannot be ignored when treating obesity. CBT is utilized in the treatment of obesity as a way to help individuals change their negative eating behaviors and incorporate healthy lifestyle changes.[9] These CBT interventions are self-monitoring techniques (e.g. food and exercise journals), stress management, stimulus control (e.g. eating only at the kitchen table), social support, problem solving, and cognitive restructuring (e.g. helping patients have more realistic weight loss goals, avoidance and challenging of self defeating beliefs).[10]
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