Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy or (CBT) is currently the popular method to provide therapy to the client with weight control maladies. CBT is ostensibly necessary to assist binge eaters and those whom suffer from tendencies to bulimic episodes. According to Brody (2007), "Most popular at the moment is cognitive-behavioral therapy, with or without medication. Since binge eaters have highly irregular eating habits, the behavioral aspect introduces structure to their eating behavior: regular meals, including breakfast, and an afternoon snack if needed." (Brody, 2007)
Rapoport, Clark, & Wardle further ascribe CBT as a comprehensive methodology to address the psychological, not neurological, deficiencies with regard to how the client addresses their weight problem. According to Rapoport, Clark & Wardle (2000), "Cognitive -- behavioural treatment (CBT) for obesity also focuses on weight loss, but incorporates psychological strategies to promote lifestyle change. Recent reviews show that CBT programmes achieve weight losses of between 5 and 20% of weight, with average drop-out rates of 20%." (Rapoport, Clark & Wardle, 2000)
According to Taylor (2010), "One such intervention that has positive impacts both on mood and obesity, either in combination or individually, is that of cognitive behavioral therapy. This type of behavioral program can be tailored to fit both a workplace type setting, or can be provided individually to employees. It has even been shown to be effective when done via the internet, providing strategies and support both to employees and employers that are unable to access tertiary healthcare centres." (Taylor, 2010)
An important research finding with regard to CBT treatment is revealed by Rodriguez-Hernandez, Morales-Arnaya, Rosales-Valdez, Rivera-Hinojosa, Rodriguez-Moran, et al. "Thus, among the strategies used to increase the rate of successful weight loss in adults, cognitive behavioural treatment (CBT), a triphasic focal psychotherapy intervention, is the most well-established psychotherapeutic treatment of problematic psychosocial functioning that characterizes eating disorders and obesity." (Rodriguez-Hernandez, Morales-Arnaya, Rosales-Valdez, Rivera-Hinojosa, Rodriguez-Moran, et al., 2009)
Indeed, according to Mefferd, Nichols, Pakiz, & Rock, "Enrolled study participants were stratified by age and BMI and assigned to either the intervention group or wait-list group. Participants assigned to the intervention group attended group sessions using curriculum based on the new elements of CBT for obesity in addition to the many elements of standard behavioral treatment for obesity, including self-monitoring, realistic goal-setting and cognitive restructuring, as applied to behavior and attitudinal change (relevant to increased physical activity, food choices, and body image)." (Mefferd, Nichols, Pakiz, & Rock, 2007)
Operational Definition & Description of Problem Behavior
The underlying problem that does result in the need for CBT is the constructs that enable the operational definition. These constructs include unhappiness, low self-esteem, and often is a function of physical or mental abuse. Unfortunately, many whom treat clients to encourage weight loss or who evaluate these patients often misunderstand the underlying psychosocial phenomena.
Weiss (2005) provides an example. "In Cognitive-Behavioral Treatment of Obesity the authors claim to present a new cognitive behavioral treatment for obesity. They deem obesity as a medical condition. The population target is patients with a body mass index (BMI) between 30 to 40; the authors disclaim experience with patients above a BMI of 40. They further claim that the use of cognitive-behavioral methods result in an average initial weight loss of about 10% of weight, with a decline in loss after four to six months of trying to lose weight." (Weiss, 2005)
Again, the underlying psychosocial factors are not addressed. According to Mefferd, Nichols, Pakiz, & Rock, (2006) "The intervention (weight-loss) incorporated cognitive-behavioral therapy (CBT), emphasizing physical activity (PA), diet modification to facilitate a modest reduction in energy intake, and strategies to improve body image and self-acceptance." (Mefferd, Nichols, Pakiz, Rock, 2006)
However, Marchesini, Natale, Chierici, Manini, Besteghi, Di Domizio, Sartini, Pasqui, Baraldi, Forlani, and Melchionda, have worked to identify the root cause leading to the contagion of obesity. "The role of obesity as a source of distress has long been proved. It is not limited to areas of physical fitness, in relation to obesity per se and associated diseases, but also involves mental status, due to the stigma of obesity and consequent social isolation. Accordingly, obesity is associated with an impaired response to domains measuring both physical fitness and mental well-being…" (Marchesini, Natale, Chierici, Manini, Besteghi, Di Domizio, Sartini, Pasqui, Baraldi, Forlani, Melchionda, 2002)
Baseline Data
The A1 baseline data provides the weekly exercise time as a function of exercise time...
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