WEEK 4- CHALLENGING OBESITY AND OVERWEIGHT: INTERVENTION AND TREATMENT STRATEGIES I Flashcards
why does management of obesity appear in different places within the NHS care system?
because obesity is a complex condition interacting with many other aspects of our health
what are the obesity management options?
GP advice, dietician input, physiotherapist advice, weight management services, medical intervention
How many tiers of the obesity care pathway is there?
4 tiers
What is tier 1 obesity care pathway?
behavioural- reinforce healthy eating and physical activity messages. includes prevention e.g public health campaigns
what is tier 2 obesity care pathway?
weight management services- lifestyle weight management services by local authorities. determined locally e.g self reffered community support group; pediatric dietician service
what is tier 3 obesity care pathway?
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
what is tier 4 obesity pathway?
surgical and non- surgical- bariatric surgery supported by MDT pre and post op. centrally funded by NHS
Who was the obesity care pathway flow chart made by?
NICE
what did the british psychological society 2019 say in the psychological perspectives on obesity?
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
what topics do clinical cousnelling and health psychologists provide support in?
mental health and wellbeing, lifestyle behaviours, illness- specific knowledge, associated risk factors (stress management; medication adherence)
what does evidence show is better than interventions not drawing on theory?
theory- based interventions
what is COM- B and what does it apply to?
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
what are the psychiological parts relevant and applicable to obesity management?
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
What are the complexities that could exacerbate obesity?
living with other conditions ie diabetes or cancer, medication side effects, systemic inflammation, genetic load, stress, bullying, habit, knowledge
what is the core competency of psychological support?
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
what are the current therapeutic approaches applied to obesity management
CBT, mindfulness, motivational interviewing, psychotherapy, behaviour therapy, person- centered therapy, relaxation therapy, hypnotherapy
how does psychotherapy work to help people with obesity?
identifying inner conflicts causing maintaining problems in peoples lives
how does humanistic therapies help people with obesity?
helping people to live according to core values
how does CBT help people with obesity?
helping overcome maladaptive patterns in people’s thoughts and behaviours
what does behaviour therapy in the context of obesity aim to do?
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
what does the cochrane review: psychological interventions for overweight or obesity suggest?
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
what is the opposing evidence for the findings by the cochrane review?
more evidence needed on cognitive/ relaxation therapies, paucity of long term studies and based on dated studies- new methods have now evolved
what are third wave therapies?
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’
what is the differences between third wave therapies and previous therapies?
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
