DIET AND PSYCHOLOGICAL SUPPORT
Psychological or psychiatric treatment is necessary when an important destructurization of the personality exists or when there is evidence of relevant anxiety-depression.
On the other hand, modification of conduct fulfils the very important role of a change in habits and can be focused on the individual or family. Its function is to support the patient, motivating them to continue with a weight-loss program, to rule out the feeling of guiltiness, provide positive stimulus, reinforce eating habits and learned activates, increasing self-confidence and decreasing anxiety. For this, cognitive-behavioural therapy is used through a series of fundamental components.
Self-Monitoring
Self-monitoring is done by keeping a dietary log (composition, quantity, time, and place) and documenting the circumstances and feelings that occur (who is present, feelings of anxiety, etc). This registry demonstrates information regarding patient habits, grade of motivation, and permit for the correction of problematic behaviour. It also makes the patient aware of their own conduct and what needs to change.
Control Of Stimulus
This includes techniques that reduce the exposure of the patient to food breaks that sequence automatic eating. Some examples of techniques to control stimulus: shopping on a full stomach, making meals at the same time and place each day, eating slowly at the table, using smaller dishes, eliminating distractions during meals, not placing receptacles full of food on the table, getting up from the table after finished eating, etc.
Techniques Of Reinforcement
Aim to balance negative and positive stimulus. Award changes in behaviour (not in weight lost).
Behavioral Contract
Specifying defined goals, with a realistic timeline in which they will be achieved that are modifiable until the final goal is realized. Establish a contract for changes in behaviour, not for changes in weight.
Social And Family Support
The people close to the patient can have a positive influence towards achieving a favourable result. It can also be a negative influence in the sense that they can incite them to have transgressions or by ridiculing their efforts. It is usually recommended that the patient look for positive support through learning how to confront these types of risky situations. In some cases therapy is necessary to teach family members how to be a helpful.
Cognitive Treatment
Cognitive therapy is needed in cases in which the obese patient has negative thoughts about themselves, their body and in all aspects of their life. This type of therapy attempts to dismantle the negative ideas and believed associations of physical appearance and life in general.