24
Non-pharmacologic Treatment
TOP 5 TAKEAWAY MESSAGES:
Behavior Therapy
1. Eating behavior in patients with increased body fat often reflects
the imbalance in physiologic forces that strongly resist weight
reduction and weakly resist weight gain. This is analogous to
the imbalanced physiologic response between hypoglycemia
(marked symptoms and strong signals to immediately consume
food) and hyperglycemia (often no symptoms and often no
signal to change eating behavior.)
2. Eating behavior is affected by all 5 senses (sight, smell, hearing,
taste, and feel), genetic predisposition, mental stress, emotions,
habitual time cues, environment, information gap, reward
factors, and psychiatric disease. Eating behavior can also be
affected by eating disorders (e.g., binge-eating disorder, bulimia
nervosa, sleep-related eating disorder [SRED] and night-eating
syndrome [NES]).
3. Physical inactivity behavior may be due to patient
musculoskeletal, neurologic, pulmonary, cardiac, and other
health disorders. Physical inactivity behavior may also be related
to fatigue, disinterest, and unhealthful environment (e.g.,
availability and excessive utilization of conveniences).
4. Behavior related to weight regain may be related to personal
and physiologic priority imbalances (i.e., "lack of time") as well as
physiologic changes of a weight reduced state.
5. Behavior therapy elements for optimal success include
promoting behaviors that are doable, efficacious, measurable,
and which engage self-ownership. Behavior therapy
implementation optimally includes frequent encounters with
qualified medical professionals, education, stimulus control,
cognitive restructuring, goal setting, self-monitoring, behavioral
contracting, problem solving, social support, and other
contingencies. These may be aided by weight management
technologies, access to healthful nutrition and physical activity
resources and/or knowing the existence of social media
resources applicable to healthful nutrition and physical activity.
