If you’re struggling with weight problems, you’re not alone. According to the Centers for Disease Control and Prevention (CDC), 69.0% percent of American adults age 20 years and over were either overweight or obese (2011-2012). In 2010, the CDC reported that 35.7% of American adults and 17% of American children were obese.
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health, leading to reduced life expectancy and/or increased health problems such as heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis. We are considered obese when our body mass index (BMI), a measurement obtained by dividing our weight by the square of our height, exceeds 30 kg/m2. This information combined with various studies indicating that dieting does not lead to sustained weight loss or health benefits for the majority of people can make weight loss goals seem daunting or unattainable. However, there are effective strategies for weight loss.
What treatments can help with weight loss?
There are many different programs available to help people lose weight and there are several categories of treatment for obesity, ranging from pharmacological treatment to surgical treatment. However, the most important is lifestyle change, with a focus on how to approach and manage this process of change. Because making changes to our lifestyles is difficult, how to make behavioral changes and what strategies to use to adhere to new ways of eating and increasing physical activity is crucial to losing weight and keeping it off. Cognitive Behavioral Therapy (CBT) is an effective treatment for a wide variety of problems, including weight loss, because it focuses on changing how you think about yourself, how you act, and the circumstances that surround how you act. Studies have found that CBT is a valuable addition to diet and exercise for weight loss, and that those who had both CBT and lifestyle changes lost more weight than those who only had lifestyle changes. The reason CBT is more effective than diet and exercise regimes alone is because it works at the underlying core issues that perpetuate gain loss cycles. By treating the underlying causes of these patterns, you are less prone to relapse.
What are some CBT strategies that help people lose weight and make lifestyle changes?
Goal setting – setting specific, attainable goals with regular feedback on progress improves outcomes.
Self-monitoring – learning to notice barriers, pay attention to physical cues and identify challenges to changing your behavior makes you better able to find ways to maintain new behaviors when initial motivation is waning.
Feedback and reinforcement – getting feedback from outside sources gives you an external measuring stick to provide motivation, help you adjust your behavior, and help keep your expectations ambitious but realistic.
Boosting the belief that you can do it – focusing not just on your behavior, but also on your perception of your ability to make the changes you want is essential, and the best way to improve your belief in your ability to succeed is to experience some success. Setting concrete and achievable goals can build your confidence to later set more ambitious goals. It can also be helpful to look for people in similar circumstances who have made the difficult changes you are trying to make and to surround yourself with people who will encourage your efforts.
Incentives – using incentives to support and reinforce desired changes in behavior can be extremely helpful in increasing motivation to regain and maintain physical health.
Lifestyle changes require sustained effort over time and whether we achieve our goals depends on how we make them, our mindset, and what we put in place to maintain motivation. The advantage of using CBT together with conventional weight loss methods is that by examining your thoughts and behaviors and improving your self-esteem and stress management strategies, you learn to use other coping skills besides food in order to attain and hold weight loss gains. This mitigates against relapse by approaching these problems both on a symptom and core belief level, instead of operating purely externally where food is the main problem.