Heli J. Roy | 4/22/2005 12:58:06 AM
Behavioral weight control therapies for obesity involve weight loss and weight maintenance, according to LSU AgCenter nutritionist Dr. Heli Roy. The most effective weight loss programs offer a combination of exercise, diet and behavioral modification.
Roy says treatment components include portion control, an exercise prescription and therapeutic component to promote long-term weight loss and maintenance strategies.
The LSU AgCenter nutritionist says obesity is a complex, multi-factorial, chronic condition. It increases the risk of several chronic diseases such as heart disease, diabetes, gallbladder disease and some types of cancer. Many different types of treatments are available today, including medication, surgical and lifestyle modification. A moderate weight loss of about 5 percent to 10 percent has beneficial effects on the risk factors associated with obesity.
Overzealous individuals may have difficulty setting reasonable goals of 5 percent to 10 percent weight loss and may get discouraged if they set weight loss unreasonably high and are unable to attain it.
Lifestyle intervention has been reported to be successful in weight reduction and the delay of chronic disease development. Behavior therapy has been used as a treatment since the 1960s, yielding moderate weight loss success.
Roy explains that the principle underlying behavior therapy is that the obese person has learned eating and lifestyle behaviors that contribute to the problem. With education and training those behaviors can be modified or new behaviors can be adopted so that the person can lose weight and make the changes as part of a healthier lifestyle. Dr. Donald Williamson and Dr. Tiffany Stewart discuss behavioral therapy treatment in a recently released "Journal of the Louisiana State Medical Society."
Behavioral treatment has the best result when a team of professionals collaborates. A medical doctor, a psychologist, a dietitian and an exercise physiologist work together during an intensive six-month to 20-week weight loss phase with a group of clients. Each client has a weight loss goal and caloric and activity prescription. Behavioral treatment focuses on changing physical activity, eating behavior and motivational strategies to improve weight loss. Longer duration programs yield better results.
"The primary goal of the treatment is to create negative energy balance, whereby caloric intake is less than energy expenditure," Roy explains. To accomplish this goal, the therapist needs several tools. These tools are self-monitoring of food intake using diet records, stimulus control to alter the environment so it becomes conducive to weight loss behaviors (such as increased activity, reduced snacking), goal setting, behavioral contracts, nutrition education, meal planning, modification of physical activity, social support, cognitive restructuring (such as teaching individuals to give positive feedback to self) and problem solving.
Meal planning is important, because it gives the client a list of appropriate foods to be consumed. This can help one reduce weight in the initial phase of the program. Also, using a shopping list helps.
Increasing physical activity is important in maintaining weight. Individuals who have lost significant weight have increased their physical activity. A typical exercise prescription in a behavioral program consists of expending 1,000 kilocalories a week in physical activity. Roy says that translates to about five hours of walking at 3 miles per hour for 150-pound person.
Promoting and choosing physical activity programs that are accessible promote greater adherence to the regimen. Including spouses, family and friends in the treatment process improves outcome.
For information on related family and consumer topics, visit the FCS Web site at http://www.lsuagcenter.com/Inst/
Extension/Departments/fcs/. For local information and educational programs, contact an extension agent in your parish LSU AgCenter office.