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Obesity Therapy

Those struggling with obesity are often best served by having an accountability partner or a therapist to hold them accountable. Therapy can help you achieve your body image goals.
Obesity Therapy
In general, obesity therapy will be a combination of psychotherapy in conjunction with a healthy diet and an exercise program.
By Jenna Jarrold, MS, LPC | Updated: January 25, 2023

What is Obesity? What Are The Causes Of Obesity?

Obesity occurs in individuals who have an excessive accumulation of body fat. Obesity is put into quantifiable terms and measured using the standard BMI (body mass index), which is a start of measurement based on height and weight. A healthy BMI for an adult falls somewhere between 18.5- 24.9. Anyone with a BMI under 18.5 is considered underweight, and those with a BMI over 25 are considered overweight. Those with a BMI of 30 or higher are classified as obese.

Obesity is often subdivided into three separate classes:

  • Class 1: BMI of 30 to < 35
  • Class 2: BMI of 35 to < 40
  • Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity.

While BMI is a helpful tool for screening purposes, it is not a diagnostic measure for assessing a person’s overall health, as it does not take into consideration the natural difference in body shapes and proportions or the density of muscle as related to fat. And while there is debate over using BMI as a tool for determining obesity, actual calculations are not often necessary to determine whether a person is overweight or obese. Excessive fat deposits and poor health tend to be the main indicators in determining whether a person is overweight or obese. For example, based on BMI, a 5-foot 9-inch male who weighs over 203 pounds is considered to be obese. Yet there are many professional athletes and/or bodybuilders who exceed these measurements yet maintain less than 10-percent total body fat. Clearly, labeling people as obese based solely on BMI is a flawed method.

While there is some debate regarding ways to measure obesity, current statistical data shows almost 40% (more than one third) of adult Americans could be considered obese, with the number continuing to climb with each passing year. Obesity rates are even higher in some developing countries due to the industrialization of their economies, growing middle class, and the ever-increasing dependence on fast food restaurants or processed food that is calorically dense but lacking in essential nutrients.

Although anyone can become obese, however women are more likely to be obese than men.

Post-Pandemic Obesity Challenge

One of the most significant changes seen during the COVID-19 pandemic was the increase in obesity rates. Whether fueled by stress, being forced to stay at home, more screen time, less physical activity, or a combination of all, nearly 42% of Americans reported weight gain one year into the pandemic. Although obesity was already a marked concern in this country, the pandemic created a significant number of challenges that only exacerbated the problem. 

Methods Used in Obesity Therapy

The methods used in treating obesity run the gamut from diet and exercise, hypnotherapy, acupuncture, medication, behavioral modification therapy or even surgery. Each case is different and there’s no single way to treat obesity or to formulate a recovery plan. Different options are effective for different people, and while one person may benefit from just having a focused nutrition and exercise plan, another person may need additional tools, skills, and support. Additional considerations such as thyroid issues can also complicate matters.

In general, obesity therapy will be a combination of one or more types of psychotherapy in conjunction with a healthy diet and exercise program. Most therapists are aware that one treatment method isn’t often enough to bring an obese person back to a healthy weight, so combined therapies within this space aren’t at all uncommon. In fact, most therapies are going to be used in conjunction with recommendations for dietary changes and a moderate amount of exercise each day.

Weight loss therapy sessions will show you just what it takes in order to achieve your body image goals.

Behavioral therapy is a common approach used to help obese individuals. Behavioral treatment is used to help individuals develop a set of skills to achieve a healthier weight. It is more than helping people to decide what to change; it is helping them identify how to change. The behavior change process is facilitated through the use of self-monitoring, goal setting, and problem-solving.

Behavioral therapy has numerous components including:

  • Identify realistic weight-loss goals
  • Explore barriers to achieving weight loss goals
  • Increase physical activity
  • Nutrition education
  • Food planning – creating a meal plan conducive to weight loss goals
  • Explore underlying cause(s) of an unhealthy relationship to food
  • Identify binge foods (if applicable)
  • Identify triggers to unhealthy food habits
  • Develop coping skills and tools to deal with triggers and overcome challenges to weight loss goals
  • Explore strategies to sustain weight loss over time
  • Behavioral therapists often ask clients to keep food logs and physical activity records.

Another method used to increase successful outcomes of weight loss is to pair behavioral therapy with medication.

Why Hire a Therapist?

Those that struggle with obesity are often better served by having an accountability partner, or a therapist who helps them to remain accountable. In addition, the proper therapist can guide you on the many facets needed to make sustainable life changes in order to bring your weight down to a healthy level. For those with thyroid, mobility or hormonal issues, a therapist may be your only hope for losing weight. It’s not uncommon for those faced with these kinds of issues to have exhausted all of the natural options to lose weight and require a professional in order to advise them on what the next steps are, from surgery to behavioral therapy or prescription drugs.

Another consideration is the immense toll obesity can take on one’s health. Obesity is linked to more than 60 chronic illnesses (i.e. – diabetes, hypertension, etc.). These health problems can not only affect a person’s overall well-being and quality of life but actually contribute to a vicious cycle preventing that person from losing weight, as various health problems restrict people’s ability to exercise.

For individuals who do not have health problems preventing them from diet or exercise, other factors, such as stress, hormonal imbalances, or depression could contribute to failed attempts at losing weight. Even if a diet has been effective for weight loss, it is not a cure for obesity, and, in most cases, weight regain will occur. This is because being obese is not really about the food. Being obese is often actually a symptom of a deeper issue. While there is no one specific cause of obesity, going to therapy can help individuals get to the core issue or contributing factor(s) of obesity. Some people have a biological cause driving their obesity, but for many, the underlying cause is more emotionally-based. Depression, anxiety, and past trauma can drive many to use food as a comfort. While a person’s worth is not based on the number on the scale, clearly it can hugely detract from their quality of life. Thus, seeking the support of a trained professional can help people navigate ways around whatever might be preventing weight loss from happening.

What to Look for When Finding a Therapist

When looking for a therapist, it is important to understand the types of treatment the therapist specializes in. That way you can choose a type of treatment that fits best with your current struggle(s), lifestyle, and overall goals. It is also important to find a therapist you feel comfortable with. Although this may be difficult to ascertain upon the first visit, over time, it is vital a supportive, trusting environment and relationship is established in order to accomplish the goals you are working towards. It is advisable to schedule an initial appointment with a couple of therapists, that way you can compare and contrast in terms of therapeutic approach, comfort level, etc..

An important consideration when going to therapy for obesity issues is the management of unrealistic expectations. One of the biggest challenges in obesity therapy is overcoming unrealistic expectations, as there is often a great disparity between expected weight loss and actual weight loss. There are certain limitations that every client has when it comes to weight loss. These could be physical, where exercise is limited, or genetic, where there are biological boundaries to a person’s weight loss.

Unrealistic expectations in obesity therapy also mean distinguishing what weight loss will and will not do for the client. While weight loss can improve physical health, and thus the overall quality of life, weight loss does not guarantee greater job success, happier relationships, etc. Discussing expectations with a therapist at the onset of therapy can be extremely helpful.

References

  • Seagle, H., Wyatt, H., & Hill, J. (2013). Obesity: Overview of treatments and interventions Nutrition in the Prevention and Treatment of Disease.
  • Seagle, H. Wing, R.R. Behavioral weight control. In: Wadden, T., Stunkard, A., et. al. (2002). Handbook of obesity treatment. New York: Guilford Press, 301–16.