psychology weight loss

8/3/2019 Psychology Weight Loss

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Lose Weight through (Mental)

KungFu!!A Psychological Approach to Obesity Prevention

Dr. Alvin Ng Lai Oon

Health Psychology Programme

School of Healthcare Sciences

Faculty of Health Sciences

Universiti Kebangsaan Malaysia

Why Psychology?

Weight management behaviour change

e.g. less energy intake, more energy expenditure

Behaviour change requires motivation

Motivation requires inspirational thoughts

Behaviour change also requires understanding of

a persons motivation, habits, triggers and

maintaining factors of a behaviour

Psychology needed to change behaviour and

MAINTAIN CHANGE!


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Psychological Approach

Methodologically changing thoughts and

behaviour in changing motivation and

feelings

Thoughts: motivation, positive thinking

Behaviour: coping skills, rewards

Outcomes = positive emotions, improved

quality of life and life skills to keep weight

healthy!

Biopsychosocial Interaction:Hot Cross Bun ModelTHOUGHTS

BEHAVIOUR

EMOTIONS

BODY FUNCTIONS

ENVIRONMENT (Physical + Social)


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Problems with Obesity

Physical

Health risks diabetes, CVD, cancer, arthritis

Psychological

Prevalence of mental disorders increases withBMI (Becker et al., 2001)

Social

Prejudice/discrimination lazy, dysfunctional, Schooling early exit

Job less likely for promotion, earn less

Relationships less chance

Usual Intervention

Self-monitoring

most important to tracking success and problems

Behavioural changes

goals and rewards for eating modifications &

physical exercise, self-monitoring

Cognitive-Behavioural methods

enhancement of self-esteem, relaxation, coping skills,

assertion training, stress management

Social support peer, family

emotional, encouragement, material resources,

information, and networking


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Psychological Approaches

Cognitive behaviour approach

Skills first, behave later

Change thoughts and learn psychological strategies

first

Implement behaviour change once skills are learnt

(helpful thinking and assertive skills)

Skills facilitate behaviour change (i.e. eating less,

more physical activities)

Why skills?

To address problems with behaviour change

i.e. dieting, increasing physical activities

When skills are in place

Change is easier with practice Stress is expected and manageable

Relapses can be handled, if not prevented

Daily motivation can be put in place


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Skills Needed

Daily motivation and reminders

Managing hunger and craving

Consistent good eating habits

Making time and energy: priorities

Respond to sabotaging thoughts bypractising (with response cards)

Coping skills regardless of triggers

Common Problems in Change

Lack of monitoring

Procrastination

Intense cravings andpreoccupation

Emotional eating

Difficultydifferentiating desire vs.actual hunger

Environmental cues

Black and whitethinking e.g. perfect dietor failure

Lack of ability to feel full

Diet only, no exercise

Social influence

Relapse


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Main Components of Weightloss Intervention

using Psychological Approach (Beck, 2008)

1. Thorough assessment

2. Realistic expectations andpriorities

e.g. target only 3kgs can dowonders

E.g. ideal weight not BMI butsettling after a balancediet/lifestyle

3. Creating time, energy andresources - priority

4. General life improvement and

stress reduction - thoughts5. Physical activity / exercise

6. Daily motivation and monitoring ofweight

7. Self-efficacy and support

8. Consistent eating habits

9. Dealing with hunger, craving andemotional eating - Normalisingeating patterns

10. Planning and monitoring food intake

11. Addressing emotional issues

12. Go towards normalcy gettingback on track

13. Nutritional counselling

14. Nutritional planning and sticking toit

15. Maintenance and relapse prevention16. Focus on healthy weight for LIFE.

www.beckdietsolution.com

Eating for Stress ReductionStress is as emotion that can be reduced by eating


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Risk Factors in Weight Gain /Weight Loss Failure

Emotional eating

Eating fast until filled

All-or-nothing thinking

Self-sabotage

Poor coping of temptations

High variety of food Television use

Usual: fast food intake, high calorie diet, lowexercise

Cognitive Model

Cognitions control behaviour reaction

Situation / Trigger Automatic

(sabotaging) thoughts ReactionBehaviour (emotional and physiological)

Mislabelling hunger

Giving self permission / excuse

E.g. Its ok because (justification to eat)

Other dysfunctional thoughts (cognitions)


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Unhelpful Thoughts Dieting has to be restrictive

Should be easy / Too hard

High expectations shoulds, or else, perfectionism

Good vs bad foods only

Hunger and cravings are intolerable

Weightloss should be consistent Biology can show otherwise e.g. hormones

Therefore need to keep weighing

Need to be full

Easily discouraged after water weight loss

Negative emotions Sabotaging permissions / entitlement vs. unfairness I can,

too

Helplessness giving up. Its not point

Unworthiness Why bother?

Preparation

Friendship and warmth in relationship

Thorough assessment

Expectations

Goals: Easy target + plan reward

E.g. 2kg and think of reward

Instill hope

Full steam ahead do it properly

Reduce shame desensitisation and restructuringnegative thoughts

E.g. weight is only a number, not an identity

Increase motivation reasons to lose weight general to specific


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Strategies

Monitor weight daily

To show direct behavioural contributions to weightchange or hormonal factors

Behavioural changes thought, regulariseeating patterns, gradual changes

Sit down, eat slowly, mindfully

Credit self with rewards

Supportive environment (social and physical) Creating time daily scheduling / plan

activities and keep to it

Fasting experiment:

Hunger is not all that bad

Experiential activity: Differentiating hunger from

craving/desire

Avoid lunch, check stomach (only when medically ok

to do so) If empty then hunger

If not empty then desire

Aim: To decatastrophise hunger

Rate discomfort and compare to other discomfort

Usually hunger is pretty mild compared to other pain

Desensitise hunger get used to it, get distracted


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Just Do It! To avoid over-eating

How I feel is irrelevant I just gotta do it

Do according to plan

Satiety kicks in after a while. Just stop eating and getdistracted.

Imagine consequences e.g. discomfort

Review motivational questions e.g. advantages vs

disadvantages Reduce opportunities

E.g. distance, distract x 5, relax, drink, readdiet/exercise/health stuff

Beat the Emo

Cope with negative emotions

Problem-solving

Respond to distorted / dysfunctionalthoughts

Accept distress let it go, and move on

Respond to excuses / permission-giving

thoughts

Anti-craving techniques


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Plan and Monitor

Cope with need for spontaneity / freedom

Planning is important and need to be

instilled

Review behavioural patterns freedom

usually leads to weight gain

Planning helps with control

Spontaneity underestimates eating

Do first, cope later

Mindful Eating Focus on really enjoying food

Eat slowly

One mouthful at a time


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Keeping On Track

Prepare in advance

Anticipate problems and difficulties

Address sabotaging thoughts

Coping skills response cards

Extra food experiments Every bite matters

Keep habit in focus, not calories

Coping with Relapses

Responses to sabotaging thoughts

Beware of self-criticism

Reward self for stopping at any point

Watch for unhelpful black/white thinking

Problem-solve

Continue planned activity / reasonable

eating


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Deal with Thoughts

Small steps to counter too hard / cant keep

it up

No choice to counter dont want

I dont care - yes, its true.. For now. But

later may care. So do something.

Dont have to now but consequences are?

Addressing Real Life Problems

Culture

Family

Travelling

Eating out

Food pushers

What else?


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Lifetime Maintenance

Lifetime eating plan

Deal with stagnancy

Lowest achievable weight vs Lowest

Maintainable Weight

Constant monitoring

Regular assessments Stay consistent as planned accept relapses and

get back on track

Become a coach

Real Life Practice for Compromise

Eat sitting down

Eat slowly and mindfully

Reward self take credit Fruits and veg at beginning of meal

Portion plate

Limit junk food and caloric drinks

Walk more every day

Have social support / coach


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Empowerment Have control over

eating/behaviour, rather

than the other way around

Learn coping skills for

factors that trigger

unnecessary eating.

Restructure unhelpful

thoughts / attitudes

Learn assertion skills

Alternative activities to

prevent over-eating

Reward effort

Groups and models can

provide good support and

motivation


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Its OK to have chocolate but the idea isto have a little and really enjoy it, insteadof going for quantity

Ruth Quillian-Wolever

Duke Center for Integrative Medicine

Approaches in Children

Positive eating messages

Inculcate positive attitudes towards eating

E.g. Eat more veggies and fruits, rather

than enforcing restrictions which lead to

future negative impact on eating behaviour

Associate healthy eating with fun and

acceptance

Actively involve parents in intervention

to support diet, physical activities, and

monitoring


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Address cognitive barriers directly

Plan long-term strategies inc. relapse prevention

Concentrate on sustainable behavioural strategies

Simple (e.g. Burn extra 100 calories a day)

Plausible (e.g. Smaller serving portions)

realistic / everyday use!

Understand the patient

Treatment guideline

Margraf. Weighty matters, 2000. Data on file. F. Hoffmann-La Roche

It is also important to

Be aware of issues affecting overweight people,

e.g. genetics, dieting, physical activities, mental

health

Understand that an overweight persons problemsare not always as a result of their weight and that

therapy does not bring thinness.

Be aware that resolving life issues doesnt

necessarily lead to weight loss


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Recommended References Cooper, Z., Fairburn, C.G., & Hawker, D.M.

(2003). Cognitive-behavioral treatment of obesity:

a clinicians guide. New York: Guilford.

Fairburn, C.G., & Brownell, K.D. (Eds.) (2002).

Eating disorders and obesity: a comprehensive

handbook. 2ed. New York: Guilford.

Beck Diet Solution www.beckdietsolution.com

National Weight Control Registry

www.nwcr.ws/

THE END

psychology weight loss

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