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Cognitive Behavioral Therapy for Obesity
 Body
shape is
closely linked to self worth and self confidence. With rising incidence, obesity,
seems to be becoming a complex long term problem, involving several categories
of treatment- lifestyle modification (reduction of energy intake
and an increase in physical
activity),
medication & surgical treatment. All agree that, obesity is a chronic disease
with multifactorial etiology, and the treatment needs to be tailored to the
individual patient.
Cognitive-behavioral therapy is based on the idea that our thoughts cause
our feelings and behaviors, not external things, like people, situations, and
events. The benefit of this fact is that we can change the way we think to feel
/ act better even if the situation does not change.
A Cognitive Behavioral Therapy study reported
in American Journal of Clinical Nutrition showed improvement in body
composition of
overweight and obese adolescents. Another recent
study published
in the Journal of the American Dietetic Association found that cognitive
behavior therapy (CBT) for weight loss produces healthier eating
habitsand
motivation for physical activity in adults and their adult family members.
Barriers in Weight loss
- ‘Goodness of fit’ between an individual and a particular weight loss
program. Every body is unique with certain personality traits, eating
patterns, temperaments, or lifestyles marking distinction between those who
succeed on one plan versus those who fail.
- Social Environment, including access to sabotage foods. The sabotage foods are
those foods which rapidly convert into sugar and have a detrimental effect
on your health and wellbeing.
- Reduced Necessity of physical activity.
- Under-estimation of cognitive component of weight loss and maintenance.
Cognitive Behavioral Therapy can go a long way to assist in weight loss by:
-
 Assisting
Diet Management: promoting
better understanding of serving
which could be one; one bag, one container, one tube of Girl Scout cookies. A
survey showed that more than 75 percent of people feel guilty about eating
so-called ‘bad’ foods. The greatest obstacle to adopting healthy eating habits
is guilt. Attaching a value to foods only makes you feel bad for eating them.
When you do decide to eat a high-fat food, enjoy it. Don’t beat yourself up over
it. Just make a special effort to eat low fat the rest of the day.
-
Accelerating motivation to exercise: In
a study conducted by West, et al it was determined that motivational
interviewing significantly enhanced both weight
loss and glycemic control
among overweight women with type 2 diabetes.
They state, “the beneficial impact of motivational interviewing was apparent
after only two sessions with significantly greater weight loss and
improvement in metabolic control at 6 months.”
-
Promoting skilled support to
handle any lapses in diet that the person will experience
-
Providing long term weight maintenance skills: CBT
can be used to reinforce the significance of the weight already lost and
encourage ongoing weight
control. There must also be an emphasis that dieting is a set of
flexible guidelines and not a set of rigid rules. A person may break their
diet on occasion and this is not the end of the world and the patient still
has control over their weight.
-
Changing a person’s body image and
their expectation of body
image. Developing and nurturing a positive body image and a healthy
mental attitude is
crucial to your happiness and wellness! CBT can help you be realistic about
the size you are. Your size is based on your genetic and environmental
history.
-
Improving self esteem: CBT
can go a long way to help you
feel good about yourself and who you are, how to carry yourself with a sense
of confidence, self-acceptance, and openness that makes you beautiful
regardless of whether you physically look like a super model. Remember, beauty is
a state of mind, not a state of your body. Do something everyday that brings
you joy. Remember, the majority of us are not models. Aim to work with your
body, not against it.
-
Helping with stress
management (a major
reason for ‘comfort eating’): Under stress, the body excretes
corticotrophin-releasing hormone and adrenalin. This reaction stimulates the
release of cortisol from the adrenal cortex. In turn, cortisol, a
glucocorticoid, stimulates glucose release into the bloodstream, which,
during periods of chronic stress, creates an excessive release of insulin.
Insulin, which is part of the endocrine system, is a fat-storage hormone
that overrides the stress signal from adrenalin to burn fat. The excess
release of insulin gives the body the message to store fat in the abdomen.
Cognitive-behavioral therapy, or CBT, can help replace negative thoughts
with positive ones.
-
Helping set reasonable goals for both weight loss and maintenance:
Society suggests to us that weight loss is simply a matter of self control.
Worsening this is our society’s obsession with body image and the constant
pressure form advertising, the media and other sources that to be slim
(often to the point of being unhealthy) is the best way to be. This results
in many people linking body image with beauty, confidence and self respect.
The result is that people set goals to lose unrealistic amounts of weight in
the hope that this will fulfill their primary goals.
Although the degree to which cognitions and behaviors (as opposed to genetics or
metabolic factors) cause obesity is a subject of great controversy, behavioral
management clearly plays a strong role in weight loss. The result of CBT is that
people become far happier with themselves and with the weight they lose
resulting in long term weight control.
Ref:
Dated 19 January 2013
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