Behavioural and psychosocial aspects of obesity and its treatment. 1994

R R Wing, and C G Greeno
University of Pittsburgh School of Medicine, PA 15213.

This chapter emphasized new directions being pursued in the behavioural treatment of obesity. Behavioural weight-loss programmes are being strengthened by their increased emphasis on low fat intake and exercise, by more direct intervention on behavioural antecedents and consequences of eating, by the use of very low calorie diets (VLCDs) and by the adoption of a chronic disease model and the concomitant lengthening of treatment programmes. With these approaches, initial weight losses of 10-20 kg can be achieved, and maintenance of weight losses of 5-10 kg can be expected. Treatments may also be strengthened by the identification of subgroups of the obese. Recently, progress has been made in this area with the description of a subgroup of the obese who have severe problems with binge eating. Binge eating disorder has been proposed as a new diagnostic category for DSM-IV. From 20 to 45% of the obese who present for treatment suffer from such problems. Obese binge eaters have worse mood and more psychopathology than obese people who do not binge eat, and are more likely to drop out of behavioural weight-control treatments. Although binge eaters may regain weight faster than non-binge eaters, both short- and long-term weight loss of binge eaters and non-binge eaters appear quite similar. Treatments have been identified that show promise in ameliorating binge eating for these patients, but these treatments have not produced weight loss. Although there has recently been concern about the possible negative effects of dieting on mood state, participation in behavioural weight-loss programmes is not associated with worsening mood in obese patients. No psychological variables have distinguished obese from non-obese individuals. Nonetheless, there is substantial prejudice against the obese. Awareness of this prejudice can lead to more sensitive and appropriate treatments for the problem of obesity.

UI MeSH Term Description Entries
D008297 Male Males
D009765 Obesity A status with BODY WEIGHT that is grossly above the recommended standards, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
D001835 Body Weight The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms. Body Weights,Weight, Body,Weights, Body
D004038 Diet, Reducing A diet designed to cause an individual to lose weight. Weight Loss Diet,Weight Reduction Diet,Diet, Weight Loss,Diet, Weight Reduction,Diets, Reducing,Diets, Weight Loss,Diets, Weight Reduction,Reducing Diet,Reducing Diets,Weight Loss Diets,Weight Reduction Diets
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001068 Feeding and Eating Disorders A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. Appetite Disorders,Eating Disorders,Eating and Feeding Disorders,Feeding Disorders,Appetite Disorder,Disorder, Eating,Disorder, Feeding,Disorders, Eating,Disorders, Feeding,Eating Disorder,Feeding Disorder
D001521 Behavior Therapy The application of modern theories of learning and conditioning in the treatment of behavior disorders. Behavior Change Techniques,Behavior Modification,Behavior Treatment,Conditioning Therapy,Therapy, Behavior,Therapy, Conditioning,Behavior Change Technique,Behavior Modifications,Behavior Therapies,Conditioning Therapies,Modification, Behavior,Technique, Behavior Change,Treatment, Behavior
D015444 Exercise Physical activity which is usually regular and done with the intention of improving or maintaining PHYSICAL FITNESS or HEALTH. Contrast with PHYSICAL EXERTION which is concerned largely with the physiologic and metabolic response to energy expenditure. Aerobic Exercise,Exercise, Aerobic,Exercise, Isometric,Exercise, Physical,Isometric Exercise,Physical Activity,Acute Exercise,Exercise Training,Activities, Physical,Activity, Physical,Acute Exercises,Aerobic Exercises,Exercise Trainings,Exercise, Acute,Exercises,Exercises, Acute,Exercises, Aerobic,Exercises, Isometric,Exercises, Physical,Isometric Exercises,Physical Activities,Physical Exercise,Physical Exercises,Training, Exercise,Trainings, Exercise

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