A series of attitudes must be modified that will result in a change in the patient’s lifestyle, when faced with obesity, to achieve the desired goals, as well as to modify the lifestyle of the obese, so that once the goal of losing weight has been achieved, there are no continuous relapses, which lead us to the same starting point, or in the worst case, the situation becomes chronic.
As can be observed in the same, the Treatment Program, is based on five basic principles: Education, Motivation, Irrational Thoughts, Exercise and Prevention of relapse. However, to achieve these principles, a series of evaluation methods and a whole series of therapeutic elements are used.
-Education: wrong ideas-calories-chain behavior-style of eating.
First, the patient is informed about a series of misconceptions he has about obesity, for example that he is obese because he only has emotional problems. In this regard it is explained that obesity is the result of an energy balance, not only of emotional problems, although these may contribute, as we will see later, to an increase in intake.
It also teaches you what are the basic nutrients for life and some elementary principles of your metabolism, so that you learn to know the caloric content of the food you eat and, vice versa, the way the body has to burn the calories consumed .
One of the best ways for a person not to consume high-calorie foods is stimulus control; for this, it is educated, among other things, how to make the so-called shopping cart, or how to get rid of those foods or situations that may motivate the intake.
-Motivation: short and long-term goals-self-control-stimulus control-ways to assign.
It is also taught the difference between different states of physiological activation that the patient can and often confused with hunger. That is to say, he is taught to correctly identify the different bodily sensations so that he does not eat because, the person feels,stressed, sad, loneliness anxiety or boredom, these latter two feelings that obese people control or resolve on numerous occasions through the intake of food.
Along with identifying the correct bodily signals, you are taught a correct eating style. Not too fast, focused on the act you are doing, if possible without watching television, or doing any other activity while eating, so that the subject manages to be aware that he is eating and that food serves him , mainly, to feed.
What should be produced a state of lack of hunger, ie satiety and for this we must focus on the food and allow time for the signs that it has eaten enough reach the areas of the brain that control the appetite.
Should motivate, if necessary, the person to carry a self-record of their meals, in which not only note the food you eat, but also the amount of calories from each of the foods, the amount of appetite I had before I started eating, the place, the time and activity I did while eating, etc.
In such a way that it is able to achieve a higher level of self-control over its intake. Finally, you should be taught to self-reinforce positively when you manage to perform the diet correctly.
-Thought: wanting not-all or nothing-right feelings.
The self-control of irrational thoughts is one of the techniques that can help the obese to control the intake more. It has been shown that, on numerous occasions, the obese eat more for what they think about themselves and their diet than for the presence of food or for their moods.
Hence, it is important to get him to learn to identify in which situations irrational thoughts appear, such as: I can not lose weight; I do not do anything right, I can not follow a regime; I’m always the same; I am a calamity, what a horror, I have skipped the diet, my work prevents me from following the diet properly, etc.
How those thoughts provoke unpleasant feelings, such as feeling irritated with himself, bored of following the regime, anxious because he does not achieve what he wants, etc., in such a way that he manages to control his irrational thoughts.
In such a way that if you manage to control your irrational thoughts and replace them with positive thoughts for example, it is not, in most cases, that slow weight loss is not a calamity, but rather that one can have a bad moment, it is not a horror to have skipped the diet in the food, one can compensate the excess of calories consumed in the rest of the meals for example.
Substituting irrational thoughts for positive thoughts produces a positive feeling in the subject and feels self-satisfied and this has the consequence that he considers himself capable of self-control not only his intake but also his lifestyle.
-Exercise: walk-schedule exercise-I can not-practice continued or weekly
If obesity depends, to a large extent, on the energy balance, one way to maintain it is through exercise. Not because the exercise causes, in the short term, a large expenditure of calories, but because it fundamentally increases the adherence to treatment, at the same time that, contrary to popular belief: exercise increases appetite, otherwise, on the contrary helps to control appetite.
Also, physical activity allows controlling the state of mood alteration caused by many diets and can be enough at least 2 to 3 hours per week, therefore no excuses.
-Relapse: eat out -as avoid a relapse-horror and excuses
Finally, one of the most important problems in the treatment of obesity is relapse. Important to avoid it is, on the one hand, analyze high-risk situations, such as eating away from home, negative emotional states, etc., on the other hand, modify the perception that the subject has of itself when it falls on excessive intake
To change these attitudes, we must put the emphasis on changing the lifestyle and for this, among the strategies mentioned, is to take into account that if a more copious meal has been made, we must compensate in the following intake through a meal lighter in calories and we should do it always and not only sometimes.
If we can not do it in the previous or next meal, it will be a pending issue, which can be approved on any other day. In case the event in question has lasted more than a week, due to vacation or travel issues, we will take it present, and as soon as possible, we put ourselves in the task of compensating for the over-supply days.
And it will be as many days as necessary and not leave it for the next month or next year, because it will be late and it is a sign that we are trapped again in the loop or vicious circle.