Module 6: Addressing the Obstacles to Weight Maintenance
Module 6 coincides with the beginning of Phase 2 of cognitive behavioural therapy for obesity (CBT-OB). Patients now attend one session every 4 weeks, over the course of 48 weeks. During this period patients are encouraged to interrupt any attempt to lose more weight and to work actively towards the long-term maintenance of the weight that they have already lost. As such, the main goal of Module 6 is to help patients develop the necessary cognitive and behavioural skills. As part of this process, patients are educated that weight maintenance is more difficult than weight loss, that some people—despite the biological and environmental pressures to regain weight—are able to maintain the weight lost in the long term and that it is necessary for them to develop and practise skills which will enable them to keep the weight off. Specific procedures introduced in this module include establishing weekly self-weighing and a weight-maintenance range, adopting eating and physical activity habits conducive to weight maintenance, constructing a mindset conducive to weight maintenance, preventing any lapses from becoming relapses and addressing any instances of weight regain. Towards the end of treatment, patients are encouraged to discontinue real-time monitoring of food intake and physical activity and to evaluate possible future weight-loss attempts, and the therapist helps them to prepare a weight-maintenance plan. Finally, patients are invited to attend post-treatment review sessions at 3-month intervals after the end of treatment for at least 1 year.
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