Cognitive behavioural therapy strategies to help people lose weight

Despite the advice to keep calm during the festive season, most of us still gain weight. Now we are in that season where we make resolutions to be better people, eat healthily, exercise, join a running club, and so on and so forth. That requires behavioural shifts that may be difficult for many to start, or to maintain.

We have learnt behaviours from our families, our friends and those close to us that are difficult to get rid of. We eat more and more and exercise less and less, we binge on fast foods and alcohol. Life becomes more sedentary and the food becomes faster. Technology has helped us to walk less and less. Why step out of your car to get that burger, chips and coke combo while they can give it to you through your car window.

Besides the weight gain, we are also at risk of developing chronic illnesses like metabolic syndrome, diabetes mellitus, hypertension etc. Because behavioural change is so difficult, many industries have been built to cash in on our struggle to change behaviour. There is now a market for crash diets, the lose weight now schemes, the diet that’s working wonders for a celebrity, the magic pills that will make you lose the weight in 21 days.

Weight loss has become a multibillion-dollar a year industry. Corporates are making a killing out of these lose weight now schemes, pun intended. Advertisers lure us with images of a healthy and happy life spent running along the beach with the sun shining overhead, then heading home to eat grapefruit and take a diet supplement. Sugar is very addictive, therefore many people struggle to cut it out of their lives.

When we eat foods that contain a lot of sugar, a massive amount of dopamine is released in an area of the brain called the nucleus accumbens. When we eat these foods often and in large amounts, the dopamine receptors start to down-regulate. Now, there are fewer receptors for the dopamine so next time we eat these foods, the effect is blunted. This is basically how sugar and other junk foods hijack brain chemistry to make us crave more.

Dieting is not the answer. Overly restrictive diets can slow metabolism, requiring further calorie restriction to lose weight. This dieting can also have negative side-effects, including depression, anxiety, irritability, obsessive thoughts about food, binge eating and not feeling full, even after a binge. The most effective weight loss programmes combine diet, exercise and psychological intervention.

As important as it is to focus on what you eat to lose weight and keep it off, it is equally crucial to consider physical activity and maintain lifestyle changes over time. The problem is that making changes to lifestyle is hard. Cognitive behavioural therapy, which focuses on changing how you think about yourself, how you act, and circumstances that surround how you act, is an effective treatment for a wide range of problems, including weight loss. Key is its focus on making changes and sticking to them.

The following cognitive behavioural therapy strategies help people to lose weight and change lifestyle behaviour

1. Set goals.

If you want to meet the goals you set, consider these three factors: the more specific a goal, the more likely you are to achieve it; ambitious goals are good, but overly ambitious goals can be discouraging; regular feedback on progress improves outcomes. When it comes to weight loss, a goal to eat nuts for dessert rather than cake is specific and can be clearly tracked. Specific goals for exercise or types of food you will eat – behaviours you have control over – are better than goals to improve body weight for instance, which may fluctuate for reasons outside your control.

2. Self-monitoring.

Self-monitoring requires that you begin to notice barriers, pay attention to physical cues and identify challenges to changing your behaviour. You may want to keep a log of your food intake or exercise routines, for example.

3. Feedback and reinforcement.

Having a healthcare provider regularly check in with you can provide an external measuring stick. Feedback about your diet or exercise routine can provide motivation or help you adjust your behaviour. Outside feedback can also help you keep your expectations ambitious, but realistic.

4. Boosting the belief that you can do it.

It is essential to focus not just on behaviour, but also on your perception of your ability to make the changes you want. The best way to do this is to have some success. Setting concrete and achievable goals, such as taking an after-dinner walk, can build your confidence to set more ambitious goals. It can also help to look for people in similar circumstances who have made the difficult changes you are trying to make and to surround yourself with people who will encourage your efforts.

5. Incentives.

The use of incentives to support change in behaviour has been extensively studied and the concept is being applied to regaining and maintaining physical health. Examples include companies that offer lower-priced onsite fitness facilities, free health coaching and insurance premium discounts to those who meet certain standards. Lifestyle changes take sustained efforts over time and whether we achieve our goals depends on how we make them, our mindset and what we put in place to maintain motivation.

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