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Behavioral management of obesity

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Abstract

The behavioral management of obesity is an approach designed to provide individuals with a set of skills that promote a healthier weight. A number of strategies are used to assist individuals in making gradual changes that can realistically be incorporated into their lives. Evidence is promising for behavioral programs, as results demonstrate an 8% to 10% reduction in initial weight during the first 6 months to 1 year of treatment. However, the long-term impact of these treatments remains unclear, as many individuals regain weight lost over time. The Diabetes Prevention Program and the Look AHEAD (Action for Health in Diabetes) trial are providing strong data on the long-term results of intensive behavioral management interventions.

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References and Recommended Reading

  1. Wadden TA, McGuckin BG, Rothman RA, et al.: Lifestyle modification in the management of obesity. J Gastrointest Surg 2003, 7:452–463.

    Article  PubMed  Google Scholar 

  2. Snyder EE, Walts B, Perusse L, et al.: The human obesity gene map: the 2003 update. Obes Res 2004, 12:369–439.

    PubMed  CAS  Google Scholar 

  3. Stubbe JH, Boomsma DI, Vink JM, et al.: Genetic influence on exercise participation in 37.051 twin pairs from seven countries. PloS One 2006, 1:e22.

    Article  PubMed  Google Scholar 

  4. Wadden TA, Brownell KD, Foster GD: Obesity: responding to the global epidemic. J Consult Clin Psychol 2002, 70:510–525.

    Article  PubMed  Google Scholar 

  5. Jones LR, Wadden TA: State of the science: behavioural treatment of obesity. Asia Pac J Clin Nutr 2006, 15(Suppl):30–39.

    PubMed  Google Scholar 

  6. Berkel LA, Poston WS, Reeves RS, et al.: Behavioral interventions for obesity. J Am Diet Assoc 2005, 105(Suppl 1):S35–S43.

    Article  PubMed  Google Scholar 

  7. Poston WS, Foreyt JP: Successful management of the obese patient. Am Fam Physician 2000, 61:3615–3622.

    PubMed  Google Scholar 

  8. Kanfer FH: Self-monitoring: methodological limitations and clinical applications. J Consult Clin Psychol 1970, 35:148–152.

    Article  Google Scholar 

  9. Trabulsi J, Schoeller DA: Evaluation of dietary assessment instruments against doubly labeled water, a biomarker of habitual energy intake. Am J Physiol Endocrinal Metab 2001, 281:E891–E899.

    CAS  Google Scholar 

  10. Carels RA, Darby LA, Rydin S, et al.: The relationship between self-monitoring, outcome expectancies, difficulties with eating and exercise, and physical activity and weight loss treatment outcomes. Ann Behav Med 2005, 30:182–190.

    Article  PubMed  Google Scholar 

  11. Elfhag K, Rössner S: Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev 2005, 6:67–85.

    Article  PubMed  CAS  Google Scholar 

  12. O’Neil PM, Brown JD: Weighing the evidence: benefits of regular weight monitoring for weight control. J Nutr Educ Behav 2005, 37:319–322.

    Article  PubMed  Google Scholar 

  13. Wing RR, Tate DF, Gorin AA, et al.: A self-regulation program for maintenance of weight loss. N Engl J Med 2006, 355:1563–1571.

    Article  PubMed  CAS  Google Scholar 

  14. Brownell KD: The LEARN Program for Weight Management 2000. Dallas, TX: American Heath Publishing; 2000.

    Google Scholar 

  15. Heymsfield SB, van Mierlo CA, van der Knaap HC, et al.: Weight management using meal replacement strategy: meta and pooling analysis from six studies. Int J Obes 2003, 27:537–549.

    Article  CAS  Google Scholar 

  16. Flechtner-Mors M, Ditschuneit HH, Johnson TD, et al.: Metabolic and weight loss effects of long-term dietary intervention in obese patients: four-year results. Obes Res 2000, 8:399–402.

    PubMed  CAS  Google Scholar 

  17. Fabricatore AN: Behavior therapy and cognitive-behavioral therapy of obesity: is there a difference? J Am Diet Assoc 2007, 107:92–99.

    Article  PubMed  Google Scholar 

  18. Wadden TA, Foster GD: Behavioral treatment of obesity. Med Clin North Am 2000, 84:441–461.

    Article  PubMed  CAS  Google Scholar 

  19. Foster GD, Wadden TA, Vogt RA, et al.: What is a reasonable weight loss? Patients’ expectations and evaluations of obesity treatment outcomes. J Consult Clin Psychol 1997, 65:79–85.

    Article  PubMed  CAS  Google Scholar 

  20. Brownell KD, Wadden TA: The heterogeneity of obesity: fitting treatments to individuals. Behav Ther 1991, 22:153–177.

    Article  Google Scholar 

  21. The Diabetes Prevention Program Research Group: Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obes Res 2004, 12:1426–1434.

    Google Scholar 

  22. The Diabetes Prevention Program Research Group: Description of lifestyle intervention. Diabetes Care 2002, 25:2165–2171.

    Article  Google Scholar 

  23. The Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002, 346:393–403.

    Article  Google Scholar 

  24. Perri MG, Nezu AM, McKelvey WF, et al.: Relapse prevention training and problem-solving therapy in the long-term management of obesity. J Consult Clin Psychol 2001, 69:722–726.

    Article  PubMed  CAS  Google Scholar 

  25. Chopra M, Galbraith S, Darnton-Hill I: A global response to a global problem: the epidemic of overnutrition. Bull World Health Organ 2002, 80:952–958.

    PubMed  Google Scholar 

  26. French SA, Story M, Jeffery RW: Environmental influences on eating and physical activity. Annu Rev Public Health 2001, 22:309–335.

    Article  PubMed  CAS  Google Scholar 

  27. Perri MG, Nezu AM, Veigener BJ: Improving the Long-term Management of Obesity: Theory, Research and Clinical Guidelines. New York: Wiley; 1992.

    Google Scholar 

  28. Wadden TA, Butryn ML: Behavioral treatment of obesity. Endocrinol Metab Clin North Am 2003, 32:981–1003.

    Article  PubMed  Google Scholar 

  29. The Look AHEAD Research Group: The Look AHEAD Study: a description of the lifestyle intervention and the evidence supporting it. Obesity 2006, 14:737–752.

    Google Scholar 

  30. Wadden TA, Butryn ML, Byrne KJ: Efficacy of lifestyle modification for long-term weight control. Obes Res 2004, 12:151S–161S.

    Article  PubMed  Google Scholar 

  31. Harvey-Berino J: Changing health behavior via telacommunications technology: using interactive television to treat obesity. Behav Ther 1998, 29:505–519.

    Article  Google Scholar 

  32. Sbrocco T, Nedegaard R, Stone JM, et al.: Behavioral choice treatment promotes continuing weight loss: preliminary results of a cognitive-behavioral decision-based treatment for obesity. J Consult Clin Psychol 1999, 67:260–266.

    Article  PubMed  CAS  Google Scholar 

  33. Wadden TA, Vogt RA, Anderson RE, et al.: Exercise in the treatment of obesity: effects of four interventions on body composition, resting energy expenditure, appetite, and mood. J Consult Clin Psychol 1997, 65:269–277.

    Article  PubMed  CAS  Google Scholar 

  34. Wing RR, Jeffrey RW: Benefits of recruiting participants with friends and increasing social support for weight loss and maintenance. J Consult Clin Psychol 1999, 67:132–138.

    Article  PubMed  CAS  Google Scholar 

  35. The Look AHEAD Research Group: Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the Look AHEAD trial. Diabetes Care 2007, 30:1374–1383.

    Article  Google Scholar 

  36. Tate DF, Jackvony EH, Wing RR: Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes. JAMA 2003, 289:1833–1836.

    Article  PubMed  Google Scholar 

  37. Tate DF, Wing RR, Winett RA: Using Internet technology to deliver a behavioral weight loss program. JAMA 2001, 285:1172–1177.

    Article  PubMed  CAS  Google Scholar 

  38. Harvey-Berino J, Pintauro S, Buzzell P, et al.: Does using the Internet facilitate the maintenance of weight loss? Int J Obes Relat Metab Disord 2002, 26:1254–1260.

    Article  PubMed  CAS  Google Scholar 

  39. Lombard DN, Neubauer Lombard T, Winett RA: Walking to meet health guidelines: the effect of prompting frequency and prompt structure. Health Psychol 1995, 14:164–170.

    Article  PubMed  CAS  Google Scholar 

  40. Boutelle KN, Kirschenbaum DS, Baker RC, et al.: How can obese weight controllers minimize weight gain during the high risk holiday season? By self-monitoring very consistently. Health Psychol 1999, 18:364–368.

    Article  PubMed  CAS  Google Scholar 

  41. Apfelbaum M, Vague P, Ziegler O, et al.: Long-term maintenance of weight loss after a very-low-calorie diet: a randomized blinded trial of the efficacy and tolerability of sibutramine. Am J Med 1999, 106:179–184.

    Article  PubMed  CAS  Google Scholar 

  42. James WP, Astrup A, Finer N, et al.: Effect of sibutramine on weight maintenance after weight loss: a randomized trial. Lancet 2000, 356:2119–2125.

    Article  PubMed  CAS  Google Scholar 

  43. Norgren S, Danilesson P, Jurold R, et al.: Orlistat treatment in obese prepubertal children: a pilot study. Acta Paediatr 2003, 92:666–670.

    Article  PubMed  CAS  Google Scholar 

  44. Poston WS, Foreyt JP: Sibutramine and the management of obesity. Expert Opin Pharmacother 2004, 5:633–642.

    Article  PubMed  CAS  Google Scholar 

  45. Torgerson JS, Hauptman J, Boldrin MN, et al.: Xenical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004, 27:155–161.

    Article  PubMed  CAS  Google Scholar 

  46. Wadden TA, Berkowitz RI, Sarwar DB, et al.: Benefits of life-style modification in the pharmacologic treatment of obesity: a randomized trial. Arch Intern Med 2001, 161:218–227.

    Article  PubMed  CAS  Google Scholar 

  47. Beliard D, Kirschenbaum DS, Fitzgibbon ML: Evaluation of an intensive weight control program using a priori criteria to determine outcome. Int J Obes Relat Metab Disord 1992, 16:505–517.

    PubMed  CAS  Google Scholar 

  48. Ratner RE, for the Diabetes Prevention Program Research Group: An update on the diabetes prevention program. Endocrin Pract 2006, 12(Suppl 1):20–24.

    Google Scholar 

  49. Perri MG, Foreyt JP, Anton SD: Preventing weight regain after weight loss. In Handbook of Obesity, edn 2. Edited by Bray GA, Bouchard C. New York: Marcel Dekker; 2007:In press.

    Google Scholar 

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Correspondence to Craig A. Johnston.

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Johnston, C.A., Tyler, C. & Foreyt, J.P. Behavioral management of obesity. Curr Atheroscler Rep 9, 448–453 (2007). https://doi.org/10.1007/s11883-007-0060-1

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