The cognitive behavioral treatment is one of the auxiliary therapeutic techniques in controlling weight. It is based in the modification of dysfunctional behaviors associated with the patient’s eating habits. These programs rise from the assumption that obesity includes a change in learning that leads to the excessive ingestion of food. Cognitive therapy has proven its efficacy in this area by working from the patient’s operating structure with the objective of causing shifts in weight and behaviors primarily related to the self-controlling of eating habits (Abreu, 2003). The assessment and correction of inadequate thoughts, which contribute both for the etiology and for the maintenance of obesity, are triggering and frequent procedures in the psychotherapeutic process for behavioral modification. To this end, we have some cognitive-based and inter-related procedures, incorporated into other behavioral programs, which include: cognitive restructuring, guided image, self-instruction training, goal setting, encouraging self-reinforcement and problem-solving, among others (Abreu, 2003).
The cognitive behavioral model identifies the core belief and the intermediary belief (rule, attitude, assumption) which leads to a thought and influences a situation or vice-versa, also triggering emotional, behavioral and physiological reactions (Vasques, Martins e Azevedo, 2004, quoting Hawton, 1997). Based in this guideline, the belief systems of overweight people have determined feelings and behaviors triggered by dysfunctional thoughts regarding weight, food and self-worth; for instance, the belief that being thin is associated with self-control, competence and superiority directly interferes in the building of a person’s self-esteem or even the belief that being thin is essential to solve life problems and so, therefore, overweight people would be miserable and prone to failures; these are all meanings that can be also found within this group (Abreu, 2003).
On the overweight person, these sets of beliefs cause dysfunctional thinking trends, forcing the development of dichotomous thoughts.
quarta-feira, 22 de dezembro de 2010
Principles for the application of CBT in the treatment of Obesity
(given the specificity of the theme, we use three references on this topic: Rodríguez, Gómez, Martínez and Pérez [2003])
The need to complement the diet and exercise guidelines with the application of weight reduction programs and prevention of weight recovery is the main challenge for the overweight patient and, therefore, it can be extremely difficult to cope with different lifestyle, which initially may prove tremendously hard. The need for daily physical exercise has to be in tune with a new diet, harder to implement but also healthier. CBT techniques are mostly directed at shifting the feeding behavior and physical exercise, through a change in attitude and the patient’s collaboration. There are numerous evidences that prove that the application of such programs considerably improves these patients’ evolution, enhancing other dimensions in the treatment of obesity. However, due to the chronic character of the disease, the therapeutic action must be prolonged throughout time, at the center of which the CBT plays a vital role. One must take notice that the entire intervention must be guided by a specialized and joint action of several healthcare providers (nutritionist, endocrinologist, doctor, etc.) and not just the psychologist (Rodríguez, Gómez, Martínez e Pérez (2003).
The need to complement the diet and exercise guidelines with the application of weight reduction programs and prevention of weight recovery is the main challenge for the overweight patient and, therefore, it can be extremely difficult to cope with different lifestyle, which initially may prove tremendously hard. The need for daily physical exercise has to be in tune with a new diet, harder to implement but also healthier. CBT techniques are mostly directed at shifting the feeding behavior and physical exercise, through a change in attitude and the patient’s collaboration. There are numerous evidences that prove that the application of such programs considerably improves these patients’ evolution, enhancing other dimensions in the treatment of obesity. However, due to the chronic character of the disease, the therapeutic action must be prolonged throughout time, at the center of which the CBT plays a vital role. One must take notice that the entire intervention must be guided by a specialized and joint action of several healthcare providers (nutritionist, endocrinologist, doctor, etc.) and not just the psychologist (Rodríguez, Gómez, Martínez e Pérez (2003).
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