3 approaches to lose weight.

Over the years, it has become generally accepted that the treatment of obesity always follows a yo-yo path. Behavior modification treatments, which began in the 1960s and 1970s, represent the first attempt to break this syndrome. This approach has its roots in Pavlov’s work on conditioned response. The principles of the “behavioral” school are based on the premise that patterns of human behavior are acquired through repetition and can be unlearned or replaced.

In the 1970s, we developed a comprehensive group treatment program led by a team that included a psychologist and a dietician. Participants were enthusiastic, but average weight loss was disappointing, and less than 10% of our regular patients were motivated to join the groups.

It appeared that if we could “weigh” what was going on in our patients’ heads and identify blockages, we could treat the causes of their problems and thus achieve much more satisfying results.

To help us do this, we created the “Mental Weight” software. To be effective in a clinical context, this software had to be user-friendly, fast and easy to interpret.

Weigh the mental attitude of the patient. This is a new concept. It analyzes the data and assigns a value that reflects the patient’s eating behavior: habits, motivation, physical symptoms of stress, emotions and personality. The results of the Mental Weight program should be identical to the ideal weight, so that it can be easily maintained. Patients can take the questionnaire every month and monitor their behavior in the same way they use a scale to monitor their weight. Since 1982, over 20,000 tests have been performed.

In addition, the results of the questionnaire provide a wealth of useful information: Eating habits (physical activity, use of food as a reward, binge eating); MOTIVATION to achieve and maintain the ideal weight; symptoms of STRESS; EMOTIONS (perfectionism, dramatization, guilt, assertiveness, signs of depression); PERSONALITY (goals, self-esteem, passivity, aggressiveness). These data are quantified on a scale and can be compared to determine the most significant factors. Variations within each factor can also be tracked on a monthly basis. Bert thus allows for a rapid assessment of the problem and the appropriate methods for its treatment. It also allows the therapist to motivate patients from month to month by showing them that changes are occurring not only in their bodies, but also in their attitudes.

It is also used to identify motivational blocks that contribute to the weight problem. It can identify over twenty possible blocks and place them on a scale according to their likelihood of being a factor (sexual blocks, fear of success, fear of failure, guilt, self-punishment, emotional stress, loss of contact with their body, etc.).

It also provides information about the experiences that cause a patient’s blocks (education, relationship with parents, personal failures, social status, etc.) After some 2,000 patients had benefited from the program, we decided to test its effectiveness. We went back to our files and selected as subjects for this study all new patients who met the following criteria:

– women between the ages of 20 and 60,
– in good general health,
– overweight by at least 18 kg (40 lbs),
– on the same low-calorie diet (600-800 kcal) supplemented with protein,
– with at least one follow-up visit,
– under the care of the same physician.

These women were then divided into three groups:

Group O:
21 patients who did not undergo any motivational treatment outside of physician visits.

Group MP:
19 patients who had completed a minimum of our motivational program, i.e., Mental Weight at least once and had read at least one motivational book.

BT group:
10 patients who had participated in our group behavioral therapy and met the other criteria.

Over the 16-week study period, the results were as follows:

– Average weight loss:
– Group O: 14.3 lbs.
– MP group: 27.7 lbs.
– BT group: 20.3 lbs.

– Dropout rate in the first month:
– Group O: 42%.
– Group PM: 4.7
– BT group: 0

– Average number of weeks on diet:
– Group O: 9 weeks.
– Group MP: 12 weeks.
– BT group: 15.3 weeks.

– Number of patients who completed all 16 weeks:
– Group O: 23.8%.
– Group MP: 52%.
– Group BT: 80%.

– Average weight loss among those who lasted 16 weeks:
– Group O: 21.2 lbs.
– Group MP: 40.1 lbs.
– BT group: 22.5 lbs.

The first conclusion that can be drawn from these results is that those who followed our motivational program lost twice as much weight as those in the other two groups.

Patients in group therapy are more determined and less likely to give up despite a smaller initial weight loss.

The results also suggest that if we could combine group therapy with our motivational program, we could expect a higher level of success.

Experience in recent years has shown that it is quite difficult to form homogeneous groups interested in group therapy. Less than 10% of our patients have expressed an interest in groups.

Finally, when we compare the results of our program to those of simple consultations with the doctor, we find twice the weight loss, 30% more motivation, a drop-out rate ten times lower in the first month and more than twice the number of patients who completed the 16 weeks.

I hear skeptics suggest that while the results of our motivational program are encouraging over 16 weeks, it will probably have little effect after two years.

I think of treating obesity much like treating high blood pressure. If one of your patients stops taking their blood pressure medication and their blood pressure starts to rise, are you going to tell them to forget about their medication or are you going to tell them that blood pressure control is a lifelong commitment that requires regular medication?

To help long-term patients maintain their weight loss and stay motivated, we have provided them with long-term motivational tools they can use at home (books, handouts, audio and video tapes).

Motivation is just like fitness. A person who wants to stay in shape must work out regularly, at least three times a week. Motivational exercises include repeating positive messages to yourself, reading positive books, listening to and watching positive programs, and surrounding yourself with positive people and thoughts.

Over the years, it has been generally accepted that treatment for obesity will always follow a yo-yo path. Behavioral therapy has provided a slight improvement. A motivational program, based on the use of the Mental Weight® questionnaire, has shown very interesting short-term results. Motivation is the key to maintaining weight loss. Remember, we are not born motivated, we are born crying. Motivation must be acquired and maintained. Encourage your patients to exercise regularly, both physically and in terms of motivation.

JF Larocque

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