A condition known as obesity involves having too much body fat. There are many ways in which a person’s health in relation to their weight can be classified, but the most widely used method is body mass index (BMI).Based on tissue mass (muscle, fat, and bone) and height, the BMI is a practical guideline used to roughly classify a person as underweight, normal weight, overweight, or obese. Major adult BMI classifications are underweight (under 18.5 kg/m²), normal weight (18.5 to 24.9), overweight (25 to 29.9), and obese (30 or more).

Obesity therapy attempts to lower body weight by reducing fat mass over the long term in conjunction with a behavioral change, which aims to minimize the risk of early mortality, incapacitation, and retirement as well as to improve risk factors linked with obesity.

A range of psychological interventions has been used in the treatment of overweight and obesity. Usually, treatments intended to treat mental health disorders have been modified into these interventions. The main goal of this kind of intervention is to lessen the psychological obstacles to changing one’s behavior in favor of a healthier one. The behavioral, cognitive, social and emotional variables that are conceptualized as barriers and therefore targeted in treatment vary depending on the theoretical underpinnings of the intervention.

A. Cognitive Behavioral Interventions

The majority of psychological interventions for overweight and obesity are cognitive behaviorally based, and are, typically used in combination with lifestyle interventions.

There are three ‘waves’ of cognitive behavioral interventions.

1. The first wave of behavior therapies focuses on changing habits as well as the causes and effects that are thought to contribute to sustaining a positive energy balance.
   
   
   
2. Second wave of cognitive behavior therapies target modification of the behaviors and thoughts hypothesized to be maintaining a positive energy balance. Problematic thoughts that are supposed to be preserving a positive energy balance are the focus of cognitive therapy.
   
   
   
3. Third wave of cognitive behavior therapies are a family of interventions (e.g., meta‐cognitive therapy, acceptance and commitment therapy , mindfulness‐based cognitive therapy , dialectical behavior therapy , and compassion‐focused therapy) targeting modification of both behaviors and reactions to relationships with thoughts hypothesized to be maintaining a positive energy balance.

B. Intensive Behavioral therapy:

Another treatment for obesity is intensive behavioral therapy. The individual learns how to modify their eating and exercise routines through this treatment. It targets poor habits that lead to obesity. These may include unhealthy eating and not exercising. The treatment uses interventions to fix these poor habits.

It educates individuals how to alter their lifestyles in order to shed weight by

• Monitor their eating habits

• Modify their surroundings to prevent overeating

• Increase their level of activity

• Make an exercise plan.

• Set realistic goals

By making these changes, one may be able to lose a lot of weight.

C. Behavior Modification

Changes in diet and exercise habits are the main objective of behavior modification treatment, to promote weight loss. Examples include:

• Setting realistic weight loss goals — short term and long term.
• Keeping a diary of their eating and exercise patterns.
• Recognizing and avoiding high-risk situations.
• Rewarding certain actions, like working out for a longer period of time or consuming less of a particular food.
• Adopting realistic beliefs about weight loss and body image.
• Establishing a support system with friends, family, and coworkers, or joining a group that can assist them concentrate on their objective.

D. Motivational interviewing (MI)

Motivational interviewing (MI) and Motivational enhancement therapy (MET) are other potential steps forward as obesity therapy. Through a nonjudgmental approach and a communication style that improves the patient’s competence, autonomy, and intrinsic drive, MI has been shown to be particularly effective in fostering behavioral change. In order to achieve a long-lasting behavioral change engaging people in a healthy attitude, the ambivalence regarding change is considered and discussed in MI, avoiding too much rigidity in directive prescriptions. The approach is not educational but aims at moving patients toward self-motivational strategies improving readiness to change.

Psychotherapies for obesity typically could help patients achieve weight loss outcome reducing dysfunctional behaviors, focusing on cognitive processes, modifying unrealistic weight goals and negative perceptions of body image, and improving psychological skills such as the client’s ability to self-monitor (eg, using diaries), stimulus control through restricting quantities of food, and behavioral modification strategies such as chewing slowly, taking time to enjoy food, and increasing awareness of the pleasure associated with taste and food.  Additionally, psychotherapies assist patients in keeping initial goals, avoiding potential relapses, and handling stressful situations using coping mechanisms.

Reference

Bischoff, S. C., & Schweinlin, A. (2020). Obesity therapy. Clinical nutrition ESPEN, 38, 9–18. https://doi.org/10.1016/j.clnesp.2020.04.013

Brennan, L., Murphy, K. D., de la Piedad Garcia, X., Ellis, M. E., Metzendorf, M. I., & McKenzie, J. E. (2018). Psychological interventions for adults who are overweight or obese. The Cochrane Database of Systematic Reviews, 2018(3), CD012114. https://doi.org/10.1002/14651858.CD012114.pub2

Castelnuovo, G., Pietrabissa, G., Manzoni, G. M., Cattivelli, R., Rossi, A., Novelli, M., Varallo, G., & Molinari, E. (2017). Cognitive behavioral therapy to aid weight loss in obese patients: current perspectives. Psychology research and behavior management, 10, 165–173. https://doi.org/10.2147/PRBM.S113278