Psychotherapy of obesity uses a psychological methods as a part of complex treating of obesity. Because obesity is related to psychological variables, clinical psychological interventions and psychotherapies are key elements to engage patients in lifestyle modification and motivate them to achieve weight loss with the help of multidisciplinary teams. Behavioral factors, such as dysfunctional eating habits and low levels of physical activity, are typically key variables and are among the main modifiable and proximal causes closely related to obesity-related complications and to simple obesity too.

Old and new cognitive behavioral techniques are successful strategies among other medical protocols and rehabilitation procedures. Behavior modification for the treatment of obesity is perhaps the most important but difficult approach. It usually involves multiple strategies to modify eating and activity habits. These strategies include: eating stimulus control, self-monitoring, problem-solving skills, cognitive restructuring, social support, and relapse prevention.

The hypnosis and mindfulness are proposed for the management of emotions and stress. Stress frequently triggers overeating which can lead to obesity. Psychological causes of stress eating and other types of emotional eating include poor awareness of internal physiological states and inability to differentiate between the hunger cues and emotional arousal. Some individuals are more susceptible to stress-induced eating than others and may adopt a self-regulation strategy for coping with aversive states in which attention is shifted away from negative self-appraisal or affect and towards the immediate stimulus environment, such as food.   

Mindfulness-based intervention may be effective in reducing stress and improving stress-related overeating. Mindfulness training reduces psychological stress and enhances psychological well-being for a variety of health conditions, may improve cortisol patterns, may reduce binge eating and other eating disorder symptoms among patients with eating disorders, and may reduce weight among obese and non-obese adults. Besides that yoga, meditation and other mind-body therapies could help in treatment of obesity; nevertheless, more research need to be done on these form of therapies in treatment of obesity.

Behavioral factors, ie, poor diet and physical inactivity are among the main proximal causes linked to obesity, obesity-related morbidity and mortality. For the successful long-term treatment of obesity, psychosocial and psychopathological variables are important elements to consider due to the relevant correlations between obesity and psychological factors such as self-esteem, quality of life, stressful life events, eating disorders, mood problems, anxiety, and personality traits. Moreover for the in-patient management of obesity, many psychological treatments with different approaches (psychoeducational, cognitive behavioral, interpersonal, systemic–strategic, psychodynamic, etc) are available.

Psychotherapies for obesity typically could help patients achieve weight loss outcome reducing dysfunctional behaviors, focusing on cognitive processes, modifying unrealistic weight goals and negative perceptions of body image, and improving psychological skills such as the client’s ability to self-monitor (eg, using diaries), stimulus control through restricting quantities of food, and behavioral modification strategies such as chewing slowly, taking time to enjoy food, and increasing awareness of the pleasure associated with taste and food. Moreover, psychotherapies work on helping patients in maintaining goals that have initially been achieved, preventing possible relapses, and managing critical situations with coping strategies. 

Psychotherapy alone is less successful than being part of a comprehensive weight-loss program that includes diet, exercise, and pharmacotherapy. Generally, there's little risk in having psychotherapy, but sometimes psychotherapy creates its own set of problems. Like any effective treatment, it must be implemented well and applied judiciously for proper indications.

There are specific traits or symptoms that may preclude the use of specific therapeutic techniques. More focus should be given not only to its beneficial effects, but also to better understand when certain techniques are best not used and could, in fact, be harmful. Adjustment disorders, post-traumatic stress disorder and relationship breakdowns can ensue for the victims and these surely are unwanted and major adverse effects of psychotherapy.

Clinical and health psychology can help patients achieve a long-term involvement in sustainable and successful weight loss programs. While weight loss programs using methods of behavior therapy and lifestyle modification approaches result, on the average, in a short-term weight loss of 10% of the initial weight, long-term effects of such programs are disappointing. Further evidence suggests, however, that long-term maintenance programs may facilitate lasting behavioral changes of patients in their daily lives and work against weight regain.

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