Abstract
Module 6 coincides with the beginning of Phase 2 of cognitive behavioural therapy for obesity (CBT-OB). Patients now attend one session every 4 weeks, over the course of 48 weeks. During this period patients are encouraged to interrupt any attempt to lose more weight and to work actively towards the long-term maintenance of the weight that they have already lost. As such, the main goal of Module 6 is to help patients develop the necessary cognitive and behavioural skills. As part of this process, patients are educated that weight maintenance is more difficult than weight loss, that some people—despite the biological and environmental pressures to regain weight—are able to maintain the weight lost in the long term and that it is necessary for them to develop and practise skills which will enable them to keep the weight off. Specific procedures introduced in this module include establishing weekly self-weighing and a weight-maintenance range, adopting eating and physical activity habits conducive to weight maintenance, constructing a mindset conducive to weight maintenance, preventing any lapses from becoming relapses and addressing any instances of weight regain. Towards the end of treatment, patients are encouraged to discontinue real-time monitoring of food intake and physical activity and to evaluate possible future weight-loss attempts, and the therapist helps them to prepare a weight-maintenance plan. Finally, patients are invited to attend post-treatment review sessions at 3-month intervals after the end of treatment for at least 1 year.
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References
Calugi S, Marchesini G, El Ghoch M, Gavasso I, Dalle Grave R. The influence of weight-loss expectations on weight loss and of weight-loss satisfaction on weight maintenance in severe obesity. J Acad Nutr Diet. 2017;117(1):32–8. https://doi.org/10.1016/j.jand.2016.09.001.
Cooper Z, Fairburn CG, Hawker DM. Cognitive-behavioral treatment of obesity: a clinician’s guide. New York: Guilford Press; 2003.
Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr. 1997;66(2):239–46.
Keesey RE, Hirvonen MD. Body weight set-points: determination and adjustment. J Nutr. 1997;127(9):1875s–83s.
Dalle Grave R, Melchionda N, Calugi S, Centis E, Tufano A, Fatati G, et al. Continuous care in the treatment of obesity: an observational multicentre study. J Intern Med. 2005;258(3):265–73. https://doi.org/10.1111/j.1365-2796.2005.01524.x.
Calugi S, Marchesini G, El Ghoch M, Gavasso I, Dalle Grave R. The association between weight maintenance and session-by-session diet adherence, weight loss and weight-loss satisfaction. Eat Weight Disord. 2018. https://doi.org/10.1007/s40519-018-0528-8.
Pacanowski CR, Linde JA, Neumark-Sztainer D. Self-weighing: helpful or harmful for psychological well-being? A review of the literature. Curr Obes Rep. 2015;4(1):65–72. https://doi.org/10.1007/s13679-015-0142-2.
McGuire MT, Wing RR, Klem ML, Hill JO. Behavioral strategies of individuals who have maintained long-term weight losses. Obes Res. 1999;7(4):334–41.
Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, et al. Diets with high or low protein content and glycemic index for weight-loss maintenance. N Engl J Med. 2010;363(22):2102–13. https://doi.org/10.1056/NEJMoa1007137.
Pronk NP, Wing RR. Physical activity and long-term maintenance of weight loss. Obes Res. 1994;2(6):587–99.
Jakicic JM, Winters C, Lang W, Wing RR. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women: a randomized trial. JAMA. 1999;282(16):1554–60.
Catenacci VA, Ogden LG, Stuht J, Phelan S, Wing RR, Hill JO, et al. Physical activity patterns in the National Weight Control Registry. Obesity (Silver Spring). 2008;16(1):153–61. https://doi.org/10.1038/oby.2007.6.
Marlatt GA, George WH. Relapse prevention: introduction and overview of the model. Br J Addict. 1984;79(3):261–73.
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Dalle Grave, R., Sartirana, M., El Ghoch, M., Calugi, S. (2018). Module 6: Addressing the Obstacles to Weight Maintenance. In: Treating Obesity with Personalized Cognitive Behavioral Therapy . Springer, Cham. https://doi.org/10.1007/978-3-319-91497-8_9
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