Obesity: psychological aspects and management.
The failure of psychological treatments to produce consistent long-term weight loss in obese subjects has led directly to a re-examination of the nature of their eating behaviour and, as stated above, to the development of new theoretical models of obesity. While behavioural therapy techniques have succeeded in producing weight losses in the region of 5 kg on average, and in the short term may be more cost-effective than drug therapy when the patients are seen in groups and by paraprofessionals, many of these subjects regain the weight lost. The majority of treatment methods involve a reduction in food intake most commonly by self-control procedures. Since recent evidence implies that the use of these techniques may derive from false assumptions, a return to individually designed treatments is perhaps the optimum strategy to maximize long-term weight loss (Wooley et al, 1979). It may be necessary to focus on relevant areas involving the wider application of behavioural therapy methods such as anxiety-management training including cue exposure and response prevention. As is most commonly suggested, a change of responses leading inevitably to overeating can be identified. The development of innovative treatment methods for obesity will require an increased understanding by therapists of the role of physiological factors in weight during and following weight loss towards a greater understanding of the factors that for him are likely to be associated with weight gain. Self-reinforcement for maintaining weight and the role of the family in promoting, facilitating, and maintaining weight loss may also be useful. However, the acknowledgement of the role of cognitive factors may eventually lead towards the development of more sophisticated treatment methodologies encompassing physiological aspects of obesity and based on social psychological theories of attitude change.