Module 4: Addressing Obstacles to Weight Loss
Module 4 is designed to help the patient to identify and address their main individual obstacles to weight loss. Patients are actively involved in identifying these obstacles through a collaborative review of their Monitoring Records and the session-by-session compilation of the “Weight-Loss Obstacles Questionnaire”. When an obstacle is identified, it is included in a personalised cognitive behavioural Formulation. This is a diagram which reports the main mechanisms hindering a patient’s adhesion to lifestyle changes and weight loss. These mechanisms generally fall into three main categories: (1) antecedent stimuli, (2) positive consequences and (3) problematic thoughts. The CBT-OB therapist should educate the patient to identify these mechanisms through real-time compilation of their Monitoring Record. Once the individual’s weight-loss obstacles have been identified and included in their Personal Formulation, specific strategies and procedures are introduced to help a patient manage their personal obstacles effectively in this module. The patient is taught to use cognitive behavioural strategies and procedures targeted at reducing exposure to environmental stimuli and addressing any events, impulses, emotions and/or problematic thoughts that influence their adherence to their eating and exercise plans; this module addresses the positive consequences of excessive eating or sedentary lifestyle and the use of food for gratification or reward.
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