Role of Behavioral Therapy in the Management of Obesity

Abstract

Behavioral therapy for obesity that is, the application of learning theory to obesity treatment is now a standard component of weight-loss programs. The hallmark of behavioral therapy for obesity is self-monitoring of eating behavior, but techniques of stimulus control, self-reward, cognitive restructuring, nutrition education, and physical activity are also emphasized. Although behavioral treatment programs that incorporate lengthier and more intensive regimens are often successful in producing short-term weight loss, most patients have regained much or all of their lost weight at long-term follow-up. One approach to this problem has been to supplement behavioral treatment with other modalities such as very-low-calorie diets, surgical procedures, and medication. Whatever the initial treatment, obesity clearly must be approached as a chronic disorder that necessitates long-term intervention, and relapse prevention and weight maintenance strategies are crucial for long-term success. Another important development in behavioral treatment of obesity has been the attempt to identify subgroups of obese persons, such as those with uncontrolled binge eating, who might benefit from specific management approaches. Treatment programs for binge eating are strongly influenced by techniques developed for other types of eating disorders such as bulimia. Although use of only behavioral therapy is insufficient, it has an important adjunctive role for many patients particularly as we improve our abilities to tailor treatment to the individual subject and to promote long-term weight maintenance.