Counseling, Weight Loss And A Lifetime Of Success

Weightloss IS 1

Individuals that experience weight gain do so for a variety of reasons, most which are not related to physical health and well being. In fact, most people that become overweight and obese have emotional issues that trigger the overeating and perceived  lack of ability to self-monitor food choices and portions. In addition these individuals often lack the emotional and cognitive support systems that could help them in changing the way that they view themselves, the relationships in their life and their relationship to food.

In a comprehensive review of over 30 years of literature on the relationship of emotional factors and obesity, it was determined that the relationship between emotions and eating is complex and very individual in nature. Not all people that were obese ate simply for anxiety-reduction, but rather the emotional issues experienced by the individuals tended to influence their choice of foods. Poor food choices and eating habits were in turn increased in times of stress or when feelings of guilt where highest. Other factors that this literature review found that were relevant to emotional eating patters included the negative emotions of boredom, anger, loneliness and depression. 1

 Other studies have implied that people that are overweight or obese do not have the ability to recognize the cues that the body provides with regards to satiation or hunger. Yet another view is the psychosomatic theory that indicates that obesity is a result of eating to alleviate or reduce anxiety and discomfort. Another popular model for research indicates that people that are overweight may chronically restrict their eating and then when stress, disinhibiting factors, or alcohol consumption occur they overeat. 2

 A recent study that compared a control group of 20 average weight adults, 20 binge eaters and 23 obese patients found different patterns in their reporting of emotions on standardize scales. The Emotional Eating Scale and the Differential Affect Scale were both used with study participants to chart their daily emotional levels and their food consumption patterns. The research showed that the binge eaters were more likely to have negative emotions throughout the day and had a high impulse to eat when interpersonal stress and anxiety occurred.  Typically anger proceeded the increased food intake.  Other factors that had a strong relationship to increased food consumption included loneliness, disgust, shame or exhaustion. 3

Regardless of the specific theory, model or hypothesis, researchers are consistent in their findings that emotions and stress factors do play a role in weight gain, weight loss and weight maintenance. Understanding how important the ability to see life circumstances in a positive light, minimize the risk of negative thoughts and emotions that cause overeating or poor eating patterns is essential for lifelong success.

The Counseling Benefit

 If negative emotions and thoughts about life circumstances, relationships and self influence how, what and why people eat, then simply changing a diet is not an effective long term solution. In order to get to the root of the problem, the individual has to become more aware of the emotional and internal aspects of weight gain and weight loss. Counseling is one of the most effective options for people to develop a deeper awareness of their eating habits and make strategic, effectively and highly personalized plans to address the root cause of their weight problem.

Cognitive and behavioral approaches or interventions to treat obesity are now considered to be hallmarks of long term success. Cognitive therapy, which focuses in on changing thoughts about specific issues, can also act as a way to increase motivation to long  term exercise programs and weight maintenance plans. The most successful cognitive restructuring exercises provide a combination of education, tailored goals, self-monitoring, stimulus control and the ability to involve significant others that can be support people, positive motivators and positive influences in the patient’s life and life goals. 4

 Counseling that combines both behavioral aspects of weight loss as well as a cognitive approach for the patient are seen as the most effective for long term weight maintenance. Patients that do not receive any therapeutic intervention are statistically likely to return to a pre-treatment weight within 3 years of achieving weight loss goals. Those with counseling that included a minimization of the psychological factors that influenced the weight gain and the positive weight loss had higher levels of adherence to weight loss and weight control behavior. 5

Options To Consider

Counseling can occur in many different forms. Traditional types of counseling are an option for some individuals where the patient and counselor meet face to face for a specific number of sessions per month or as scheduled. Technology now provides additional options as well. Patients can work with therapists and counselors in a virtual world using e-counseling, e-therapy, chat systems and even group support meetings all via the internet.

In addition, cognitive and behavioral therapy can be easily provided as phone therapy. In fact, phone therapy has already been proven to be highly effective.  The less traditional approaches to applying obesity counseling can be effective in that it teaches people how to self monitor and learn stimulus control in their life environment.7 It’s also makes it much more convenient for clients to access counselors and therapists when they really need help instead of waiting for an appointment.

Research using different models of counseling in working with obese individuals with Binge Eating Disorder found that patients that were treated through inpatient sessions and those completing telephone-based outpatient treatment had the same overall results, with the type of counseling a great predictor of the long term adherence to weight loss than the mode by which the counseling occurred. 6 This is positive news for those patients that cannot attend traditional in-patient treatment or live in areas where face to face meetings with counselors are not practical.


1 Ganley, R. M. (1989). Emotion and eating in obesity: A review of the literature. International Journal of Eating Disorders , 343-361.

2 Canetti, L., Bachar, E., & Berry, E. M. (2002). Food and emotion. Behavioral Processes , 157-164.

3 Zeeck, A., Stelzer, N., Linster, H. W., et al. (2011). Emotion and eating in binge eating disorder and obesity. European Eating Disorders Review , 426-437.

4 Dalle Grave, R., Calugi, S., Centis, E., et al. (2011). Cognitive-Behavioral Strategies to Increase the Adherence to Exercise in the Management of Obesity. Journal of Obesity .

5 Cooper, Z., & Fairburn, C. G. (2001). A new cognitive behavioural approach to the treatment of obesity. Behaviour Research and Therapy , 499-511.

6 Castelnuovo, G., Manzoni, G. M., Villa, V., et al. (2010). Brief Strategic Therapy vs Cognitive Behavioral Therapy for the Inpatient and Telephone-Based Outpatient Treatment of Binge Eating Disorder: The STRATOB Randomized Controlled Clinical Trial. Clinical Pratice and Epidemiology in Mental Health , 29-37.

7 Berkel, Laverne A, Walker S. Carlos Poston. (May 2005) Behavioral Interventions for Obesity. Journal of the American Dietetic Association, 105 (5). P 35-43.


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