Weight loss counseling is a group or individual therapy designed to help overweight people change their behaviors and habits, so that they can get healthy and lose weight. Weight loss counseling interventions are designed to help bring about lifestyle changes and identify the root cause of unhealthy eating behaviors such as binge eating or extreme restrictive diets.
WHAT IS WEIGHT LOSS COUNSELLING?
Weight loss counselling is a space where you can unpack and make sense of your struggle with weight, food, eating and your body.
Many of our clients come to weight loss counselling because they want to understand and change their unhelpful patterns of thinking, behaviour and emotions connected to their weight and eating.
We want to understand how your relationship with food and eating makes you feel, what triggers your self-sabotaging behaviour, how your weight impacts your daily life, and the thoughts you have about your body and appearance.
Weight loss counselling can help you make positive changes to your eating habits and behaviours, help you develop greater emotional agility, and is a space where you can build self-esteem and confidence. as you develop a healthy relationship with food and your body.
IS WEIGHT LOSS COUNSELLING FOR ME?
Weight loss, yo-yo dieting, weight gain and emotional eating are all stations on an emotional rollercoaster – once you get on it is very difficult to get off. This has a huge effect on our self-worth, body image and our health.
Have you been on every diet going? Have you lost weight, gained weight, felt full of self-loathing and doomed to a life of being overweight?
Do you feel ashamed about being fat, or being called obese? Are you feeling hopeless, frustrated and helpless in being able to lose weight? Do you feel like a failure?
Over time our self-belief becomes eroded and we focus on our lifetime of weight loss failures, leaving little space in our head to focus on what we can do to change our situation. If this sounds like your story, then weight loss counselling is for you.
Why Does Therapy Help You Lose Weight?
Nearly 70% of adults in America are considered overweight or obese. With the number of overweight individuals growing every year in this country, it is becoming more obvious that the traditional routes of weight-loss (diets, exercise, etc.) are not cutting it. But the issue with being overweight is not simply aesthetics in terms of body shape and size. Being overweight is a serious health risk as it can lead to other medical problems such as diabetes, high blood pressure, sleep apnea, kidney disease, certain types of cancer, and many more. Not only does being overweight increase the risk for medical/physical problems, but also mental health problems. In general, people who are overweight tend to struggle with low self-esteem, increased anxiety, and depression. Clearly, being overweight can significantly impact a person’s life, and seeking a non-traditional approach to weight loss might be the key to success.
Weight loss therapy is a form of cognitive behavioral therapy (CBT), which is an approach to psychotherapy used to treat a multitude of issues. Cognitive behavioral therapy helps people increase awareness to, and eventually challenge and change, the negative cognitions (or thoughts) that often drive the “unhealthy” behaviors. CBT can also help people get to the core of the problem, as the relationship with food is often just the symptom of a deeper issue.
Recently, the scientific and medical communities have begun to sing the praises of CBT for weight loss benefits. Several large profile studies have detailed the effectiveness of cognitive behavioral therapy as a supplement to traditional diet and exercise. The studies have shown that patients using CBT in addition to diet and exercise showed more dramatic and long-lasting changes to their overall body composition than those that used just diet and exercise, or just cognitive behavioral therapy.
While CBT can be a great addition to one’s weight loss journey, it is not necessarily a substitute for healthy lifestyle decisions such as getting appropriate amounts of exercise or choosing foods that support the weight loss goals.
Methods Used in Weight Loss Therapy
Upon the initial meeting with a weight loss therapist, they will likely conduct an assessment. An assessment typically consists of questions about physical and mental health history, relationship to food, and lifestyle choices.
Long-term goals for weight loss and food/exercise will also be established in the initial session. In subsequent meetings, the long-term goals will be broken down into smaller steps to create a sort-of action plan as to how the goals will be achieved.
Through a series of lifestyle changes including meal planning (which is individually tailored to the client and their specific goals), and following an exercise program, weight loss can be achieved. In addition to the lifestyle changes, working with a weight loss therapist can help increase one’s understanding about their relationship to food, and identify any underlying issues that might contribute to weight gain, overeating, negative body image, etc. Although all therapists are different, CBT for weight loss typically involves one or many of the following approaches or strategies:
- Goal setting
- Self-monitoring
- Feedback and reinforcement
- Increasing personal motivation and belief in self
- Incentives
Upon achieving weight loss/body composition goals, the therapist may continue to guide you on healthy lifestyle choices, and tools and skills to help with maintenance.
Holistic Weight Loss Counseling
My approach to weight loss counseling is practical, holistic, based in proven science that promotes whole-body health and customized to your specific body type, lifestyle, needs and personal goals. This comprehensive approach considers all aspects of your life—from thoughts and behaviors that either promote or hinder weight management and ongoing life stressors to medical concerns and even past or present trauma—and helps regulate your nervous system through stress management and somatic techniques so it becomes receptive to losing weight. Rather than focus on yet another specific diet, the goal of our work is changing the relationship you have with food. While shifting ingrained patterns usually isn’t a quick fix and requires a strong commitment to change, this holistic approach is highly effective, successful and sustainable over time.
In our initial therapy session, we’ll engage in a comprehensive assessment that considers all aspects of your life. Based on information, needs and goals, I’ll devise a customized plan designed to help you think differently about food and feeding. Together, we’ll identify obstacles or resistances that could get in the way of goals and address any issues that come up as you heal your relationship with food and, ultimately, yourself. As an expert in mood and food issues, I can help and support you in resolving feelings of anxiety, depression and unresolved trauma, continually working toward regulating your mood as well as repairing your relationship with food. Everything is interconnected and to truly make peace with food, you get to make peace within yourself.
In sessions, we’ll also bring the sacred back into eating as you identify eating patterns that no longer serve you and begin to shift the way you think about food. You’ll learn mindfulness techniques and practices that help you build awareness, slow down and truly savor nourishing, whole foods. Those who eat mindfully tend to be more successful in managing weight over time, and taking the time to consider how your food tastes, where it came from, and the processes that got it from the Earth to your plate can help you both appreciate what you’re eating and tether food to your values.
I will also help you develop tools to mitigate stress and regulate your nervous system, including breathing techniques and exercise which help to improve mood. While you can’t outrun your fork, and many people overeat after exercising thinking that they burned enough calories and have “earned” the extra food, moving your body in joyful ways supports long-term success. It’s also important that you chose activities that you love. When you feel better—mind, body and spirit—you are more likely to feel more connected to your body, make better food choices and move toward optimal whole-body health.
Weight Management Counseling Using a Targeted Lifestyle Patterns Approach
Because overweight and obesity typically coexist with type 2 diabetes,weight management counseling is an integral function of diabetes clinicians. However, the task can be daunting with the limited time and resources available and with patients who vary in their attitudes, abilities, and cultural backgrounds. Furthermore, diabetes clinicians differ in their skill sets and competency regarding delivery of obesity care.
The cornerstone of treatment for overweight and obesity is lifestyle intervention, which involves counseling on diet, physical activity, and behavior.1 Although some clinicians may lack confidence in their diet and nutrition background,others may feel challenged giving exercise advice, and others still may not know what to do when stress interferes with their patients’ weight loss efforts. To improve confidence in counseling skills, clinicians would benefit from using an efficient, targeted approach that is easy to understand and follow, is comprehensive, covers the three aspects of lifestyle modification,and addresses each patient’s individual needs. A new weight management counseling method that accomplishes these goals is the Lifestyle Patterns Approach.
Pattern Recognition
Pattern recognition, also known as heuristics or intuitive thinking, is an innovative approach to counseling. Pattern recognition is familiar to diabetes clinicians when reviewing the relationship between a patient’s blood glucose, meals, and medication administration. Adjustments in meals and medications are made after reviewing a patient’s blood glucose patterns. For obesity care, diet, physical activity, and behavioral counseling are adjusted based on a patient’s lifestyle patterns. This is the basic premise underlying this new counseling method. Figure 1 depicts a lifestyle patterns organizational chart showing the seven lifestyle patterns in each of these three dimensions.3
These 21 patterns were developed intuitively after treating thousands of overweight patients during the past 25 years. By taking a previously validated 50-item questionnaire, patients find out, for example, if their eating pattern is that of a Meal Skipper, a Convenient Diner, or a Hearty Portioner; if their exercise pattern is that of a Couch Champion, an All-or-Nothing Doer, or an Uneasy Participant; and if their coping pattern is that of a People Pleaser, a Fast Pacer, or an Overreaching Achiever. The qualitative lifestyle pattern names help clinicians connect quickly with patients. “You pegged me,” is a frequent comment clinicians hear when using this approach. And feeling understood is often the springboard for an empathetic and therapeutic clinician-patient relationship.
Focused Counseling
The overall goal in weight loss counseling is to help patients consume fewer calories and eat more healthfully. However, patients have different obstacles in their way. Lifestyle pattern identification helps to identify behavioral obstacles. Some people travel a lot and depend on restaurant food for their meals, whereas others eat healthfully during the day but become nighttime nibblers when they are relaxing at home. Identifying a patient’s particular struggles when it comes to eating will help clinicians focus their counseling. How and when a patient eats can be as important as what and how much they eat.
Regarding exercise, knowing the recommended exercise guidelines for general health, weight loss, and weight maintenance is important, but it does not help personalize this information to patients sitting in a clinic office. Some patients may want to exercise but do not have the time, whereas others are all-or-nothing type exercisers, and still others have a functional limitation that affects their ability to exercise. Knowing the attitudes and motivations behind your patients’ struggles with becoming more active gives clinicians a clearer picture of how to help each particular patient.
The coping aspect of lifestyle patterns counseling refers to how people view themselves, relate to others, and cope with stress. Often, clinicians are less comfortable addressing this area of weight loss counseling, and yet in our research, this is the most problematic dimension of weight control as identified by patients. In a study of 335 overweight patients in a clinical setting, all seven coping patterns were endorsed by > 50 % of the patients,compared to five eating patterns and three exercise patterns. Clearly,patients need help in this area. Using principles of cognitive behavioral therapy, clinicians are able to help their patients develop more positive coping skills by assisting them, for example, to tackle their emotional eating behaviors, lessen their tendencies to procrastinate, or put their self-care higher up on their to-do list.
After the interactive questionnaire is scored, patients can view the results, which consist of three separate lifestyle pattern profile graphs in the dimensions of eating, exercise, and coping. A sample eating patterns profile graph is shown in Figure 2. Similar exercise and coping pattern profile graphs are also displayed for patients who complete the questionnaire. A patient’s lifestyle patterns questionnaire results are unique—no two patients have identical results. Pattern scores range from 0 to 100% for the 21 patterns. The higher the score, the greater is the likelihood that a particular pattern is a dominant one requiring attention during counseling.