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Module 2: Changing Eating

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Abstract

Module 2 of cognitive behavioural therapy for obesity (CBT-OB) trains the patients to change their eating habits to produce a 500–1000 kcal energy deficit per day. This should provide a weight loss of about 0.5–1 kg/week, although results will vary patient by patient and week by week. Patients are encouraged to follow a low-energy eating plan based on the Italian Mediterranean diet, but this should be adapted to the preferences and characteristics of the individual, as well as the patient’s personal metabolic targets. To improve adherence to dietary restriction, CBT-OB suggests that patients adopt the following three procedures: (1) planning ahead when, what and where to eat in the Monitoring Record, (2) monitoring food intake in real time in the Monitoring Record and (3) eating consciously (i.e. slowly, while appreciating the smell and taste of food) and adopting a mindset focused on weight control. Patients are advised to follow the meal plan without being influenced by external or internal stimuli that may negatively influence their adherence. They are encouraged to tolerate the short-term aversive experiences and loss of pleasure that they may experience when following an energy-restricted meal plan and instead to focus on their long-term goals (e.g. reaching a healthy weight loss and its associated physical and psychological advantages).

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References

  1. Fairburn CG. Cognitive behavior therapy and eating disorders. New York: Guilford Press; 2008.

    Google Scholar 

  2. Mancini JG, Filion KB, Atallah R, Eisenberg MJ. Systematic review of the Mediterranean diet for long-term weight loss. Am J Med. 2016;129(4):407–15.e4. https://doi.org/10.1016/j.amjmed.2015.11.028.

    Article  PubMed  Google Scholar 

  3. Schwarzfuchs D, Golan R, Shai I. Four-year follow-up after two-year dietary interventions. N Engl J Med. 2012;367(14):1373–4. https://doi.org/10.1056/NEJMc1204792.

    Article  PubMed  CAS  Google Scholar 

  4. Gotsis E, Anagnostis P, Mariolis A, Vlachou A, Katsiki N, Karagiannis A. Health benefits of the Mediterranean Diet: an update of research over the last 5 years. Angiology. 2015;66(4):304–18. https://doi.org/10.1177/0003319714532169.

    Article  PubMed  Google Scholar 

  5. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25 Pt B):2985–3023. https://doi.org/10.1016/j.jacc.2013.11.004.

    Article  PubMed  Google Scholar 

  6. Dalle Grave R, Calugi S, Corica F, Di Domizio S, Marchesini G, QUOVADIS Study Group. Psychological variables associated with weight loss in obese patients seeking treatment at medical centers. J Am Diet Assoc. 2009;109(12):2010–6. https://doi.org/10.1016/j.jada.2009.09.011.

    Article  PubMed  Google Scholar 

  7. Fabricatore AN. Behavior therapy and cognitive-behavioral therapy of obesity: is there a difference? J Am Diet Assoc. 2007;107(1):92–9. https://doi.org/10.1016/j.jada.2006.10.005.

    Article  PubMed  Google Scholar 

  8. Franz MJ, Barr P, Holler H, Powers MA, Wheeler ML, Wylie-Rosett J. Exchange lists: revised 1986. J Am Diet Assoc. 1987;87(1):28–34.

    PubMed  CAS  Google Scholar 

  9. Dalle GR. Perdere e mantenere il peso. Verona: Positive Press; 2015.

    Google Scholar 

  10. Fairburn CG. Cognitive-behavioral treatment for bulimia. In: Garner DM, Garfinkel PE, editors. Handbook of psychotherapy for anorexia nervosa and bulimia. New York: Guilford Press; 1985. p. 160–92.

    Google Scholar 

  11. Grilo CM, White MA, Wilson GT, Gueorguieva R, Masheb RM. Rapid response predicts 12-month post-treatment outcomes in binge-eating disorder: theoretical and clinical implications. Psychol Med. 2012;42(4):807–17. https://doi.org/10.1017/s0033291711001875.

    Article  PubMed  CAS  Google Scholar 

  12. Astrup A, Brand-Miller J. Macronutrient composition and obesity treatment. In: Brownell KD, Walsh BT, editors. Eating disorders and obesity: a comprehensive handbook. 3rd ed. New York: Guilford Press; 2017. p. 480–7.

    Google Scholar 

  13. Muller MJ, Bosy-Westphal A. Reply to MG browning. Am J Clin Nutr. 2016;103(3):953–4. https://doi.org/10.3945/ajcn.115.127282.

    Article  PubMed  CAS  Google Scholar 

  14. Frey-Hewitt B, Vranizan KM, Dreon DM, Wood PD. The effect of weight loss by dieting or exercise on resting metabolic rate in overweight men. Int J Obes. 1990;14(4):327–34.

    PubMed  CAS  Google Scholar 

  15. Estruch R. Ros E, Salas-Salvado J, Covas MI, Corella D, Aros F, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med, 2018. 378(25):e34.

    Google Scholar 

  16. Widmer RJ, Flammer AJ, Lerman LO, Lerman A. The Mediterranean diet, its components, and cardiovascular disease. Am J Med. 2015;128(3):229–38. https://doi.org/10.1016/j.amjmed.2014.10.014.

    Article  PubMed  Google Scholar 

  17. Sacks FM, Lichtenstein AH, Wu JHY, Appel LJ, Creager MA, Kris-Etherton PM, et al. Dietary fats and cardiovascular disease: a presidential advisory from the American Heart Association. Circulation. 2017;136(3):e1–e23. https://doi.org/10.1161/cir.0000000000000510.

    Article  PubMed  Google Scholar 

  18. Briggs MA, Petersen KS, Kris-Etherton PM. Saturated fatty acids and cardiovascular disease: replacements for saturated fat to reduce cardiovascular risk. Healthcare (Basel). 2017;5(2):29. https://doi.org/10.3390/healthcare5020029.

    Article  Google Scholar 

  19. Bouvard V, Loomis D, Guyton KZ, Grosse Y, Ghissassi FE, Benbrahim-Tallaa L, et al. Carcinogenicity of consumption of red and processed meat. Lancet Oncol. 2015;16(16):1599–600. https://doi.org/10.1016/s1470-2045(15)00444-1.

    Article  PubMed  Google Scholar 

  20. Willett WC, Skerrett PJ. Eat, drink, and be healthy: the Harvard medical school guide to healthy eating. New York: Free Press; 2017.

    Google Scholar 

  21. Giacco R, Della Pepa G, Luongo D, Riccardi G. Whole grain intake in relation to body weight: from epidemiological evidence to clinical trials. Nutr Metab Cardiovasc Dis. 2011;21(12):901–8. https://doi.org/10.1016/j.numecd.2011.07.003.

    Article  PubMed  CAS  Google Scholar 

  22. Rolls BJ. The relationship between dietary energy density and energy intake. Physiol Behav. 2009;97(5):609–15. https://doi.org/10.1016/j.physbeh.2009.03.011.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017;46:1029–56. https://doi.org/10.1093/ije/dyw319.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Bertoia ML, Mukamal KJ, Cahill LE, Hou T, Ludwig DS, Mozaffarian D, et al. Changes in intake of fruits and vegetables and weight change in United States men and women followed for up to 24 years: analysis from three prospective cohort studies. PLoS Med. 2015;12(9):e1001878. https://doi.org/10.1371/journal.pmed.1001878.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Tan SY, Dhillon J, Mattes RD. A review of the effects of nuts on appetite, food intake, metabolism, and body weight. Am J Clin Nutr. 2014;100(Suppl 1):412s–22s. https://doi.org/10.3945/ajcn.113.071456.

    Article  PubMed  CAS  Google Scholar 

  26. Dalle Grave R, Pasqualoni E. Perdere peso con gusto. 100 ricette AIDAP per perdere e mantenere il peso. Verona: Positive Press; 2017.

    Google Scholar 

  27. Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011;111(1):92–102. https://doi.org/10.1016/j.jada.2010.10.008.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hollands GJ, Shemilt I, Marteau TM, Jebb SA, Lewis HB, Wei Y, et al. Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco. Cochrane Database Syst Rev. 2015;(9):Cd011045. https://doi.org/10.1002/14651858.CD011045.pub2.

  29. Heymsfield SB, van Mierlo CA, van der Knaap HC, Heo M, Frier HI. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int J Obes Relat Metab Disord. 2003;27(5):537–49. https://doi.org/10.1038/sj.ijo.0802258.

    Article  PubMed  CAS  Google Scholar 

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Dalle Grave, R., Sartirana, M., El Ghoch, M., Calugi, S. (2018). Module 2: Changing Eating. In: Treating Obesity with Personalized Cognitive Behavioral Therapy . Springer, Cham. https://doi.org/10.1007/978-3-319-91497-8_5

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  • DOI: https://doi.org/10.1007/978-3-319-91497-8_5

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