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Holistic Psychotherapy Approach to Weight Loss

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A holistic approach to weight loss is one that involves changing the thought process around eating, food choices and emotions as well as addressing the behavioral or physical issues that contribute to weight gain and to weight loss. By looking at the entire person instead of just one or the other aspect of dieting and weight loss a much more comprehensive, individualized and successful short and long term weight loss program can be developed.

This therapy, known as Cognitive Behavioral Therapy or CBT includes elements of classical therapy as well as specific components that are designed to address the behavioral issues that are involved in unhealthy eating habits. Various studies have shown that for binge eating disorder as well as a wider range of eating disorders cognitive behavioral therapy is most effective although not a guarantee of success in all patients with these types of disorders. 1

The major reason provided by most studies as to why pure cognitive behavioral therapy is not successful is because of the lack of standardization of procedures between professionals. It studies where the program is designed specifically for the patient and considers all the stressors, emotional barriers and the realities of the person’s environment the results tend to be much more positive. A holistic approach to psychotherapy provides all these factors.

Cognitive Behavioral Therapy

Behavioral therapy addresses the physical aspects of weight loss including how to eat, exercise levels, patterns or eating and the environment that hosts these patterns. Typically this aspect of the holistic psychotherapy approach will include specific educational components about healthy food choices, portion control, the types, duration and intensity of exercise and the importance of changing the individuals overall lifestyles around these areas.

As mentioned above, Binge Eating Disorder (BED) has been the focus of many cognitive-behavioral therapy studies to treat the behavioral and emotional issues at the root of the eating disorder. Interestingly, in studies where CBT was used in conjunction with specific behavioral weight loss therapy, it was found that the individuals that had CBT alone did better in reducing binge eating short term but that behavioral weight loss therapy produced higher rates of actual weight loss. Individuals that had more weight loss, a better body mass index or BMI rating, tended to have better remission from binge eating episodes over longer periods of time. 2

The same study indicated that there was no specific sequence of behavioral weight loss training followed by CBT, rather it was the overall improvement in the body mass index that motivated the study participants to continue on with their lifestyle changes and healthy eating goals. In other words, looking at the whole person and using techniques to provide sustainable weight loss was the greatest predictor of overall success in long term weight loss or binge eating remission.

Technology Based Counseling for the Long Run

Having the ability to meet personally with a counselor may offer a good option in long term weight loss and weight maintenance. In study of 1032 obese adults in a weight loss study, it was found that those that had even brief personal contact with a counselor had high rates of sustained weight loss. These participants had all lost a specific amount of weight, at least 4 kg in a 6 month weight loss phase, but the second phase included in-person counseling, technology based counseling or a self-directed weight maintenance program. The individuals in the technology-based counseling did equally well as the in person counseling and both did much better than the self directed group after 30 months. 3

The therapist, either online, on the phone or in person is able to connect with the patient and build a strong understanding of their thoughts about eating, what triggers them to eat and how to use a tool known as cognitive restructuring. Cognitive restructuring allows a client to change his or her thoughts about a specific event or situation from a negative and potentially harmful thought into a more rational and positive thought. People can learn how to think differently about mistakes, triggers and emotions and avoid the habit of using food as an anxiety reducer, comforter or as a way to punish themselves.

 Motivation is Essential

Being able to motivate obese and overweight individuals to change their lifestyles is also part of the goals of holistic psychotherapy. Research with sedentary obese individuals, all women, showed that extremely obese individuals that were provided with education and the opportunity for supported exercise programs lost weight. The weight loss was not just due to increased activity levels and caloric expenditure, there was also an awareness of psychological changes that led to increased weight loss. 4

This concept is not new, that the psychological change in thinking about things can actually lead to better physical well being. The mind and body are healed together, creating the best possible option for positive changes. Health promotion by changing the way people think has been linked to changes in motivational levels, self-efficacy beliefs and changes in basic health habits.5 This, in essence, is the benefit of holistic psychotherapy, changing individual thinking patterns about food, food choices and the environment to optimize motivation, increase health awareness and create a climate for weight loss and weight loss maintenance for life.

 References

1 Wilson, T. G., Grilo, C. M., & Vitousek, K. M. (2007). Psychological treatment of eating disorders. American Psychologist , 199-216.

2 Grilo, C. M., Masheb, R. M., Wilson, T. G., et al. (2011). Cognitive–behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge-eating disorder: A randomized controlled trial. Journal of Consulting and Clinical Psychology , 675-685.

3 Svetkey, L. P., Stevens, V. J., Brantley, P. J., et al. (2008). Comparison of Strategies for Sustaining Weight Loss. Journal of the American Medical Association , 1139-1148.

4 Annesi, J. J., & Gorjala, S. (2010). Changes in Theory-Based Psychological Factors Predict Weight Loss in Women with Class III Obesity Initiating Supported Exercise. Journal of Obesity .

5 Bandura, A. (2004). Health Promotion by Social Cognitive Means. Health Education And Behavior , 143-164.

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