The Cognitive-Behavioral Therapy , together with a correct physical training plan and an appropriate dietary plan, is shown to be a very effective alternative in losing weight.

Therefore, and contrary to what many individuals think, the training of people with overweight and obesity requires not only intervention in the technical aspects related to training and nutrition, but the fulfillment of the objectives and, above all, the maintenance of the results, is also going to depend on the correct management of the emotions, the habits and customs, the beliefs or the motivation .

The multifactorial and chronic nature of obesity requires a multidisciplinary program

There are many causes of obesity. Its multifactorial and chronic character which, on many occasions, is accompanied by comorbidity , means that a quick and definitive solution to this problem is not sought. No one can doubt the importance of a physical training plan and an adequate dietary plan, but it is necessary to pay attention to the psychological component , since on many occasions Eating Disorders (ED), anxiety disorders or mood disorders such as depression, among other pathologies, can be associated.

Therefore, this very varied and complex context requires a treatment in which a multidisciplinary program must be prioritized, instead of separate solutions .

Obesity causes serious health problems

Many of the individuals who seek solutions to the problem of obesity are motivated by a change of image , leaving aside the problems for their own health. In many cases, they think that with a proper diet and a physical exercise routine to lose weight, the problem will be solved, avoiding other areas of their lives that are just as important.

When “losing weight” is approached more as an image problem and the treatment is directed in this direction, this biased view makes it possible to avoid modifying life habits and behavior, which are the ones that will ultimately bring long-term benefits. Scientific studies indicate that, in these cases, only between 20% and 30% of patients with obesity manage to maintain the results achieved in the long term . But even worse, during the first year, 30% of people who have undergone a plan to reduce obesity regain the weight lost, and more than 50% gain more weight than initially after 3-5 years.

Group and individual psychotherapy, both useful in the treatment of obesity

The therapeutic approach can be applied either in a group or individually, although each approach must be carried out in different situations.

The group therapy will be useful for the communication of experiences and for educating the patient, as providing knowledge about the importance of prioritizing health over aesthetics is useful for maintaining long-term results. Individualized therapy is necessary in cases where the patient must be treated for issues such as body image perception, self-esteem, impulsivity, problem-solving style or mood disorders.

Motivation and psychoeducation to prepare the patient for therapy

The scientific data support the theory that psychological treatment combined with diet and exercise programs provides better results . The problem arises because many still think that exercise and nutrition programs will be sufficient to achieve success. Therefore, there are two key elements in this process, and they are very interrelated: motivation and psychoeducation .

The importance of motivation

motivation is a key aspect in achieving success in any type of task, and is a necessary prerequisite when attending group therapy for the treatment of obesity. As mentioned above, the main goal of many individuals is still physical achievement, as doctors’ advice to lose weight (because it causes health problems) is often ineffective.

For many, participating in a psychotherapy group is not in their initial plans. And although psychotherapy is effective in overcoming many problems, including obesity, on many occasions the person who needs help is not aware that they have the problem, avoids facing reality or has false beliefs about what psychotherapy is.

It is important, therefore, and to keep patients motivated, that they value the benefits not only on a physical level, but on a general level. Having high expectations due to misinformation is a source of dissatisfaction that can lead to failure and disinterest in following up on treatment, due to feelings of frustration and lack of motivation. Furthermore, this negatively affects one’s self-confidence, which is necessary to successfully overcome the objectives set .

One way of solving this problem may be motivational interviewing , a style of managerial interaction, centred on the client, aimed at helping people and encouraging them to compare the advantages and disadvantages of the harmful habits that cause overweight and obesity, in order to bring about positive changes.

Psychoeducation is a key element in achieving long-term results

A psychoeducational program is necessary for the correct development of motivation, both in the short term and for the maintenance of the results obtained. It is quite frequent that people with obesity have already tried to carry out diets and training plans without achieving the desired results in the past, and they usually have excessive but inadequate information about diet or physical exercise.

On many occasions, they tend to have “infoxication” due to the culture of aesthetics. They think that the results will come quickly and have thoughts about unrealistic weight changes, fruit of their irrational beliefs . In a culture that values image as one of the keys to personal success and social acceptance, it is not surprising that this is the case.

Therefore, and in order to avoid inappropriate thoughts and expectations, the patient should attend psychoeducational sessions, in order to gain knowledge about diet, the influence of emotions on behaviour or physical exercise and health.

The application of individual Cognitive-Behavioral Therapy programs

On many occasions, people with obesity suffer from comorbidity with certain psychological disorders that can interfere with the evolution and treatment of the program and therefore need to be detected. For example, the presence of Eating Disorders (e.g. binge eating disorder), night eating syndrome or depression is common. This requires individualized treatment from the beginning of the program to ensure the correct adherence to the treatment and the achievement of the objectives set .

Other types of problems, such as low self-esteem, impulsiveness, or negative problem-solving styles, may also require individualized therapy. For this, different cognitive-behavioral techniques are often used.

These are the most common:

  • Self-monitoring techniques : Self-monitoring, record sheets, realistic goal setting or stimulus control, are techniques that have been shown to be effective in this area.
  • Cognitive Restructuring : Cognitive restructuring programs by Aaron Beck, Albert Ellis or other authors, can help the patient to have knowledge about his own emotions or thoughts when faced with different problematic situations, as well as detect irrational thoughts and replace them with more adaptive ideas or beliefs.
  • Focus of work : Working on self-esteem, self-efficacy beliefs, perception of body image, reinforcement of achievements is beneficial for the treatment of obesity.
  • Development of difficulty management skills : It is positive for the patient to acquire knowledge about alternative behaviours instead of eating, social skills training, assertiveness or stress management strategies.
  • Re-evaluation and Feedback : Especially useful for the follow-up and evolution of the changes produced.

Psychological tips for weight loss

You may want to take a look at this article:

“10 psychological tricks to lose weight”

Bibliographic references:

  • Lafuente, M.D., (2011) Eating Disorders 14. 1490-1504.
  • Wing, R.R., Phelan, S., (2005) Long-term weight loss maintenance. Am J Clin Nutr. 82 Suppl 1: 222-225.