Management of Individuals Who Are Obese: Behaviour Modification and Other Aspects
Permanent changes in lifestyle are necessary for long term weight maintenance after weight reduction. Behavioural modification is the main approach to help patients make these changes. The best and most economical way to attempt behavioural modification is group therapy, in which a trained therapist works with 10 to 15 participants. Behavioural modification includes stimulus control, self-monitoring and cognitive restructuring. The main method of reducing energy intake is to reduce the fat content of food. An important part in increasing physical activity is to adopt lifestyle exercise. Weight reduction can be augmented with very low calorie diets. These must be used only in association with intensive behavioural modification to ensure maintenance. Despite intensive investigation, pharmacological therapy for obesity is not yet fully satisfactory: current drugs are recommended only for selected patients, and should be used together with behavioural modification. Obesity surgery is the therapy of choice for some selected cases with severe or morbid obesity.
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