Assessment

•individual assessment is considered essential in understanding

the factors contributing to and maintaining the individual's weight
gain social context, goals and expectations of treatment are
important to achieve a multifactorial formulation of the problem
and in assessing readiness to change
Goal setting
•to encourage the individual to aim for modest weight losses,
which can be maintained.
•learning principle of successive approximation ±breaking a task
into small achievable goals
•monitoring their outcome
Self-monitoring
•Keeping a food and activity diary
•a good basis for increasing awareness and planning for and monitoring
change
•helps to identify the actual amount of food consumed and when, and helps
to identify the specific problem areas to be targeted in treatment.
Functional analysis
•a detailed analysis of the occurrence of behavioursthe individual
wishes to change
•Using the eating and activity diary, analysingthe antecedents
(cues) and the consequences (reinforcers) of a behaviourhelps the
individual to target aspects of his or her environment, or response
to the environment, which can be modified.
•eliminate the associations between stimuli and urges to eat, through
exposing the individual to the trigger (e.g. looking at food) and inhibiting
their usual response (i.e. eating).
•Exposure induces a dramatic increase in the urge to eat but this usually
reduces over a 5±30 minute period, giving the person an experience of
selfcontrol.
Cognitive restructuring techniques
•the process of identifying, challenging and modifying unrealistic or
maladaptive thoughts
•record their automatic thoughts, find the evidence for and against these
thoughts/beliefs and substitute more helpful alternatives.
•focus on challenging unhelpful thoughts during the initial phase of setting
weight loss goals (e.g. I'm only going to be happy if I'm a size 10) and when
dealing with lapses
Relapse prevention
•Preparing the individual to appreciate that lapses (slips) are a natural part of the change
process
•predict situations which might cause a lapse, and to problem solve thinking of coping
strategies before high risk situations arise.
•restructure a lapse as a learning experience and not as failure
•Continuing self-monitoring and functional analysis helps to identify triggers which lead
to the lapse and problem solve what might be done differently next time

Managing body image, binge-eating and well-

being
•emphasizing self-acceptance, improved body image, better nutrition and increased
rates of physical activity
•educational approaches to challenge the negative stereotypes regarding obesity, the
identification and modification of negative thoughts and beliefs about physical
appearance and exposure to avoided body image situations
•Interventions to improve body image may turn out to be a key component of
treatments for overweight/obesity
•Body image dissatisfaction correlates with low mood and low self esteem.
Fertility -1

Obesity -1 (CBT)

Addictive behavior+ stress-1

calculation on diet, analyses diet, design

PA