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PSYCH310 > WEEK 4- CHALLENGING OBESITY AND OVERWEIGHT: INTERVENTION AND TREATMENT STRATEGIES I > Flashcards

WEEK 4- CHALLENGING OBESITY AND OVERWEIGHT: INTERVENTION AND TREATMENT STRATEGIES I Flashcards

1
Q

why does management of obesity appear in different places within the NHS care system?

A

because obesity is a complex condition interacting with many other aspects of our health

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2
Q

what are the obesity management options?

A

GP advice, dietician input, physiotherapist advice, weight management services, medical intervention

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3
Q

How many tiers of the obesity care pathway is there?

A

4 tiers

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4
Q

What is tier 1 obesity care pathway?

A

behavioural- reinforce healthy eating and physical activity messages. includes prevention e.g public health campaigns

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5
Q

what is tier 2 obesity care pathway?

A

weight management services- lifestyle weight management services by local authorities. determined locally e.g self reffered community support group; pediatric dietician service

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6
Q

what is tier 3 obesity care pathway?

A

multi- disciplinary team- clinician led service including consultant, GP, specialist nurse, dietician, psychologist, psychiatrist, physiotherapist e.g community or secondary care based specialist services- mostly in hospital based settings and provided by NHS

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7
Q

what is tier 4 obesity pathway?

A

surgical and non- surgical- bariatric surgery supported by MDT pre and post op. centrally funded by NHS

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8
Q

Who was the obesity care pathway flow chart made by?

A

NICE

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9
Q

what did the british psychological society 2019 say in the psychological perspectives on obesity?

A

human behaviour change is complex and efforts to change can benefit from behaviour change support

1) should take into account complex array of causes
2) should minimise stigma at all opportunities
3) behaviour change science should inform all management approaches
4) obesity care should include psychology input
- they said wherever there is obesity management there needs to be a focus on behaviour change

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10
Q

what topics do clinical cousnelling and health psychologists provide support in?

A

mental health and wellbeing, lifestyle behaviours, illness- specific knowledge, associated risk factors (stress management; medication adherence)

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11
Q

what does evidence show is better than interventions not drawing on theory?

A

theory- based interventions

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12
Q

what is COM- B and what does it apply to?

A

capability, opportunity, motivation and behaviour model- this model reocgnises that behaviour is part of an interacting system involving all these components - applies to behaviour change of overweight and obesity

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13
Q

what are the psychiological parts relevant and applicable to obesity management?

A

maintainence of behaviour change, post- surgery support, pre- surgery assessment and weight loss support, opportunity to prevent excess weight gain, opportunity to consider obesity in context of other issues

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14
Q

What are the complexities that could exacerbate obesity?

A

living with other conditions ie diabetes or cancer, medication side effects, systemic inflammation, genetic load, stress, bullying, habit, knowledge

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15
Q

what is the core competency of psychological support?

A

psychologists combine psychological evidence and their clients’ personal thoughts, feelings and meanings through a collaborative sense making’ process to develop a shared account that indicates the most helpful way forward

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16
Q

what are the current therapeutic approaches applied to obesity management

A

CBT, mindfulness, motivational interviewing, psychotherapy, behaviour therapy, person- centered therapy, relaxation therapy, hypnotherapy

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17
Q

how does psychotherapy work to help people with obesity?

A

identifying inner conflicts causing maintaining problems in peoples lives

18
Q

how does humanistic therapies help people with obesity?

A

helping people to live according to core values

19
Q

how does CBT help people with obesity?

A

helping overcome maladaptive patterns in people’s thoughts and behaviours

20
Q

what does behaviour therapy in the context of obesity aim to do?

A

enhancing dietary restraint, providing adaptive diet strategies, discouraging maladaptive diet practices, increasing motivation for physical activity, coping skills to manage cues for overeating, skills to manage lapses in diet/ activity change plans

21
Q

what does the cochrane review: psychological interventions for overweight or obesity suggest?

A

psychological therapy adds to diet/ exercise alone (therapy resulted in losing approximately 2.5-5kg more than control groups) - the more intensive the psychological therapy the better- cognitive behaviour therapy better than behaviour therapy alone

22
Q

what is the opposing evidence for the findings by the cochrane review?

A

more evidence needed on cognitive/ relaxation therapies, paucity of long term studies and based on dated studies- new methods have now evolved

23
Q

what are third wave therapies?

A

they prioritize the holistic promotion of psychological and behavioural processes associated with health and well- being over the reduction or elimination of psycholigcal and emotional symptoms although that typically is a ‘side benefit’

24
Q

what is the differences between third wave therapies and previous therapies?

A

previous therapies aimed to change content of thoughts and feelings that lead to obesity related behaviour whereas third wave therapies instead aim to change our responses to those thoughts or feelings

25
Q

what are examples of third wave therapies?

A

acceptance and commitment therapy, dialectic behaviour therapy, functional analytic psychotherapy, motivational interviewing

26
Q

what are the two aims of acceptance and commitment therapy in obesity

A

Aim 1: reduce experiential avoidance leading to short- term negative reinforcement of eating behaviour (function of problem behaviour) Aim 2: increase new values consistent behavioural repsonses (function of new healthier behaviour)

27
Q

what is experiential avoidance?

A

attempted avoidance of negatively evaluated thoughts/ feelings even when doing so incurs negative consequences ie eating when you feel sad about being fat - same with alcohol smoking ect

28
Q

what are the key concepts of motivational interviewing?

A

rolling with resistance, managing ambivalence, respecting autonomy, capitalising on change talk, person- centred planning

29
Q

which area is there a lot of evidence that motivational interviewing is effective?

A

the addiction field

30
Q

what is the conventional opposite view of motivational interviewing?

A

persuasion, suggestion giving, righting reflex, expert- recipient relationship

31
Q

what has a larger effect size than behavioural interventions?

A

motivational interviewing

32
Q

what should minimum- weight loss interventions aim for?

A

to prevent weight regain

33
Q

what are the disadvantages of motivational interviewing?

A

costly and time intensive, accessibility- relatively new approaches inrecognized/ untrained workforce, strengthening evidence base needed, barriers to implementation exist (stigma and policy)

34
Q

what are the advantages of motivational interviewing?

A

addresses complexity, reflects emerging evidence base on behaviour change and psychological support, impact on multiple outcomes, build upon traditional approaches, can be delivered alongside other very different approaches, potential for long term cost reduction

35
Q

what are all the obesity interventions?

A

third wave therapies, CBT’s, behavioural therapies, lifestyle modification, lifestyle advice, wait and monitor

36
Q

why is lifestyle modification not sustainable?

A

the modification often stops when the study stops

37
Q

what do none of the obesity interventions take into account?

A

other effective strategies outside individual approaches, environment change, taxation, policy, food availability, social norms

38
Q

what is CHAMP services?

A

children with a high BMI referred to clinic where they help children and parents change behaviours- service is now decommissioned

39
Q

how to the intervention tiers work?

A

tiers go from the least intervention to the most intervention (4= the most severe)

40
Q

what do guidelines call for?

A

psychologists to be a part of obesity care

PSYCH310 (9 decks)

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