Behavioral Modification for the Management of Obesity (original) (raw)
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Behavioral Approaches to the Problems of Obesity
Behavior Modification, 2000
Obesity is a complex and increasingly prevalent disorder that can confer a number of medical, social, and psychological difficulties. As a result, an array of treatment strategies falling under the generic umbrella of "behavior therapy" have been developed and continue to be refined and expanded. In this article, different behavioral approaches to the problems of obesity are outlined and reviewed, specifically, those that target (a) body weight or composition, (b) lifestyle factors and other health-related variables, and (c) related psychological variables such as self-esteem and assertiveness, as well as negative attitudes toward obese persons held by nonobese individuals. For each of these targets of change, approaches to both individual-and group-level interventions are considered. Suggestions for future research and clinical work are offered. Throughout, the importance of conceptualizing obesity as a multifaceted problem is underscored. The necessity for explicit target goals when attempting to modify behavior is also highlighted.
Behavioral Interventions for Obesity
2005
Because of the increased risk of comorbid conditions such as type 2 diabetes, hypertension, and osteoarthritis, and the high health care costs associated with obesity, researchers and clinicians continually search for low-cost and effective treatments for weight loss and weight maintenance. In this article we provide an overview of the principles of behavior modification as applied to the treatment of obesity, examine the benefits of augmenting behavioral interventions with pharmacotherapy, and review the use of less-traditional applications of behavior modification in the treatment of obesity, specifically Internet interventions, meal replacements, and telephone interventions. Based on our review, we conclude that these less-traditional approaches can be used effectively to apply the principles of behavior modification, specifically stimulus control and self-monitoring, to obese patients. Future directions for research are outlined, which include examining the use of nontraditional behavioral interventions with children and the development of culturally sensitive interventions for racial and ethnic minority populations.
Motivational Interviewing and Dietary Counseling for Obesity in Primary Care: An RCT
Pediatrics, 2015
Few studies have tested the impact of motivational interviewing (MI) delivered by primary care providers on pediatric obesity. This study tested the efficacy of MI delivered by providers and registered dietitians (RDs) to parents of overweight children aged 2 through 8. Forty-two practices from the Pediatric Research in Office Settings Network of the American Academy of Pediatrics were randomly assigned to 1 of 3 groups. Group 1 (usual care) measured BMI percentile at baseline and 1- and 2-year follow-up. Group 2 (provider only) delivered 4 MI counseling sessions to parents of the index child over 2 years. Group 3 (provider + RD) delivered 4 provider MI sessions plus 6 MI sessions from a RD. The primary outcome was child BMI percentile at 2-year follow up. At 2-year follow-up, the adjusted BMI percentile was 90.3, 88.1, and 87.1 for groups 1, 2, and 3, respectively. The group 3 mean was significantly (P = .02) lower than group 1. Mean changes from baseline in BMI percentile were 1.8...
Behavioral intervention for the treatment of obesity: Strategies and effectiveness data
2007
The obesity epidemic has been recognized in the professional and lay public as a major health problem in the United States and many other cultures. The gastroenterology literature has recently paid attention to this problem, focusing primarily on either physiological mechanisms of obesity or surgical remedies for obesity. However, behavioral strategies developed from social learning theory have been the most thoroughly tested interventions for the treatment of obesity, as well as the interventions shown most clearly to have clinical benefit. Nevertheless, descriptions of behavioral techniques and their theoretical underpinnings have been minimal in the gastroenterology literature. Here, a brief history and presentation of the theoretical underpinnings of behavioral strategies for obesity management is summarized, emphasizing some of the key components, treatment effectiveness data, and needed areas for further research. Overall, it is concluded that behavior therapy is both the most studied and most effective therapy for treating obesity at present. Gastroenterologists are encouraged to use it as a first line of treatment for most obese patients, and as a key component of therapies that involve pharmacologic and surgical components.
Behavioral and medical management of obesity
South Dakota medicine : the journal of the South Dakota State Medical Association, 2011
South Dakota physicians are confronted by an epidemic of obesity. Developing an effective management strategy for patients with this condition can be daunting. This article reviews the evidence behind dietary, exercise-based, and pharmacological approaches to the care of the overweight and obese patient, offering recommendations to the clinician based on this evidence.
Patient Education and Counseling
Objective: To test and optimize the feasibility and acceptability of a physical activity (PA) and healthy eating behavior change intervention for obese adults with obesity-related co-morbidities or additional risk factors for co-morbidities. Methods: Open-pilot intervention study using an uncontrolled pre and post design with ongoing measures on intervention acceptability and feasibility. Participants received 5 weekly nurse-led onehour long group sessions. Acceptability and feasibility were assessed throughout. PA, dietary behavior and weight were measured before and after the intervention. Results: Of 74 consenting participants, 61 (82%) received and 47 (64%) completed the intervention. Average ratings of intervention materials and components by participants ranged between 4.1 and 4.9 out of 5. Average facilitator satisfaction rating was 90% (range 75-100%). The intervention delivery was feasible as indicated by ratings and comments from participants and the facilitator. Participants lost À0.86 kg of weight t(45) = 3.84, p = 0.0001, and increased PA by an additional 1.6 (SD = 2.7) sessions/ week, t(31) = À3.3, p = 0.002. No significant dietary differences emerged. Conclusion: The intervention was acceptable to the facilitator and participants and feasible for delivery. Several intervention aspects were further optimized.
Obesity Counseling and Guidelines in Primary CareA Qualitative Study
American Journal of Preventive Medicine, 2007
Background: The problem of obesity is now epidemic in the United States. Despite the existence of clinical guidelines for prevention and treatment of obesity and documented clinician concern about this problem, counseling for obesity reduction in primary care is infrequent. The principal aim of this study was to examine the views of clinicians on obesity counseling and to compare these views to the recommendations of leading obesity guidelines. Methods: Twenty individual, in-depth interviews and two focus groups of clinicians serving predominantly low-income minority populations were conducted in a practice-based research network. Data were analyzed using immersion/crystallization and template approaches. Results: Clinicians believe obesity is an important problem and report using mostly brief, targeted, low-intensity counseling in the face of limited patient motivation and lack of resources to support weight loss. They view family, cultural, social, and community factors as central to the problem of obesity, and their own efforts as generally ineffective. These clinicians similarly were unconvinced of the long-term effectiveness of any weight-loss strategies. Conclusions: Low levels of obesity counseling in primary care may reflect clinicians' self-assessment of their ineffectiveness in this area rather than lack of interest or knowledge. These clinicians perceive that obesity control efforts aimed at local community factors and environmental modifications are key strategies in augmenting and linking their efforts to successful outcomes.