Behavioral Weight Management for Weight Loss

Overview of Behavioral Weight Management Program for Weight Loss

Behavioral Weight Management (BWM) involves modification of thoughts and behaviors related to eating, activity, and lifestyle. Emphasis is placed on adopting a healthy lifestyle that includes knowledge of nutrition and exercise, positive attitudes and expectations for weight loss, and motivation for positive change. Internal motives include improved health, increased energy, self-esteem and personal control; realistic goals are necessary for successful weight loss; that is, 1-2 pound weight loss per average week thru commitment to small, incremental changes in patterns and behaviors. Lifelong weight management success is obtained through daily commitment to positive behavioral changes and kindness toward oneself. Above all, clients are encouraged and directed to adopt new and healthy patterns of coping for more effectively managing stress/negative emotions/difficult social situations as a way of replacing negative patterns of using food/drink as coping strategies that have perpetuated weight and self-image issues.

Through the BWM program that I offer, I am dedicated to providing quality services designed not only to improve eating behaviors and weight patterns but also to enhance compliance with diverse components of medical regimens. If through our work you can get rid of a blood pressure medicine or other medicine treating weight-related co-morbidities, what a success! Ultimately, my hope is to help reduce incidence of obesity and advance overall health-related behaviors throughout our communities.

How does the program work? Through ongoing evaluation, short-term counseling, mentoring, and various options for follow-up and behavioral relapse prevention all in the interest of cultivating and maintaining more effective eating and weight management strategies, I educate clients each week with a variety of life skills that will serve them through the years. This is NOT a diet program with short-term goals. During our work together, you will work toward establishing and sustaining healthy lifestyle change and weight management.

*Note to those pursuing bariatric surgery:

I can help you too!  In addition to providing services designed to improve nutrition and weight management, I offer psychological evaluation for individuals pursuing bariatric surgery options. The BWM program I offer is quite well-suited for clients who have already scheduled or hope to obtain approval for bariatric surgery. How? By guiding clients through healthy eating and lifestyle changes, including portion control, meal distribution, communication/coping skills, and enhanced awareness of internal and environmental triggers associated with their personal eating patterns, the BWM program helps clients to demonstrate advanced initiative and commitment to the significant changes in eating and behavioral modification needed to predict adjustment to post-surgical demands and significant changes in eating patterns. In other words, this program will help to optimize the likelihood of post-surgical success.

Program Breakdown

On average, participation in the BWM program involves completion of a 60- to 90-minute initial intake session, where we will review your feedback on extensive paperwork involving your personal history. Specifically, prior to our initial meeting, participants of the BWM program will be asked to complete a general intake questionnaire and the Weight and Lifestyle Inventory (WALI), a highly detailed questionnaire about the genetic, environmental, emotional, and family background that will help me to devise an individualized treatment plan to best suit the client’s specific needs.  Questions will incorporate nature of your coping patterns for managing stressful situations and relations, relationship history, mental health history, activity patterns, and goals for treatment. Once we agree on treatment goals, we will proceed with 12-15 weeks of 45-minute individual treatment sessions, targeting development of new habits/patterns of behavior through review of daily food records and caloric/fat intake, exercise behaviors, introduction/review of specific weekly skills designed to foster healthy lifestyle change. Clients are empowered to assume control over their choices, feelings, and behaviors while fostering new relationships with food. Food stops becoming a reward or social system, as healthier relationships, personal accountability, and emotional self-care and nurturing patterns take over.

Please note, the BWM program is also well-suited for bariatric surgery candidates motivated to proactively establish and sustain the significant life changes necessary for post-surgical success (please see below for more information).

The Behavioral Weight Management program includes a number of components, including but not limited to:

  • FORMAL ASSESSMENT MEASURES
  • WEEKLY TREATMENT SESSIONS TARGETING SPECIFIC SKILLS RELATED TO HEALTHY LIFESTYLE CHANGE
  • BEHAVIOR MANAGEMENT TRAINING
  • NUTRITION EDUCATION (DAILY FOOD DIARIES ARE AN INTEGRAL COMPONENT OF THIS PROGRAM)
  • CONSULTATION WITH YOUR PHYSICIAN, AS APPROPRIATE, REGARDING PROGRESS, POSSIBLE MEDICATION EFFECTS/CHANGES, AND REALISTIC BWM GOALS
  • PHYSICAL ACTIVITY/EXERCISE
  • STRESS MANAGEMENT STRATEGIES
  • ASSERTIVENESS TRAINING

 

While this may all sound daunting, rest assured skills are introduced slowly and skillfully and your progress is regularly monitored to optimize your success in the program.  Commitment to program goals is essential, however, for success.  As treatment proceeds, referrals may be offered for more specialized services, such as nutritionist, personal training, or specialist physician follow-up procedures; follow-thru is of course at client’s discretion. Of note, most clients who complete the BWM program enjoy ongoing psychotherapeutic follow-up to explore and address longstanding issues that may have contributed to original weight gain, development of maladaptive coping patterns, and relationship matter. Continued follow-up also allows for ongoing weight loss support, maintenance, and relapse prevention efforts; frequency of meetings can vary from weekly to monthly depending on client needs and interests.

 

For Bariatric Surgery Candidates:

For candidates decidedly pursuing bariatric surgery, I offer a number of options, ranging from psychological evaluation required by many facilities prior to surgery to education and rehearsal of significant changes needed for optimal post-surgical recovery and success.  Given the gravity of risks associated with surgical procedures and the importance of post-surgical diet and lifestyle changes, evaluations are completed to assess preparedness for surgery and knowledge of behavioral changes necessary to optimize likelihood of post-surgical success. Interested applicants will be asked to meet for a 90- to 120-min. clinical interview and evaluation designed to inform impressions and recommendations regarding appropriateness and preparedness for surgery. A written report will be provided to your surgeon, and a feedback session will be scheduled to review with you the results of the assessment, including recommendations regarding pre- and post-surgical considerations, as appropriate. Please know that there are no guarantees that evaluation will deem you an appropriate candidate for surgery. It is essential that you educate yourself regarding pros and cons and arm yourself with knowledge before proceeding, as surgery is a high-risk approach to weight loss. Among the many factors to consider in determining your candidacy for surgery are:

  • Realistic expectations for weight loss
  • Nutritional education and counseling on significant changes needed to diet after surgery (calorie restriction, portion control)
  • Family/Social support post-surgery
  • Family eating patterns
  • Exercise
  • Supplements (since surgery interferes with your eating and possibly digestion, malnutrition and related health problems may follow, such as brittle bones or anemia)
  • Follow-up medical visits
  • Access to post-operative medical and psychological follow-up to assess adjustment/coping

           
It is not uncommon for patients to experience the suboptimal outcomes after surgery, including less than expected weight loss, premature weight regain, and frequent vomiting and/or gastric dumping particularly when not adhering to recommended diet regimen (Sarwer, Dilks, & West-Smith, 2011, Journal of Surgery for Obesity and Related Diseases, 7(5), p. 644-51). Reasons for these outcomes are likely due to behavioral and physiologic processes. Pre-surgical knowledge of and commitment to changes in dietary intake and eating behavior needed for post-surgery may prove invaluable for optimize post-operative success. As such, the BWM program I offer to clients seeking behavioral strategies for weight loss can be offered and/or adapted as an additional avenue for those seeking surgery to prepare themselves with the skills and education needed to facilitate post-operative adjustment while enforcing also a solid support system.

APPROPRIATE REFERRALS:

  • Adults (18 and over) classified as overweight or obese

 

INAPPROPRIATE REFERRALS:

  • Individuals under the age of 18
  • Individuals suspected to have or diagnosed with an eating disorder, such as Anorexia, Bulimia, or Failure to Thrive
    • If such concerns appear relevant at the time of intake, measures will be taken to refer client to more appropriate sources of support.