Cognitive Behavior Therapy:
Cognitive behavior therapy is based
on changing the individual’s erroneous ways of thinking about themselves, the world and how others perceive them. It
is thought that individual’s disordered “schema” of thoughts perpetuates self defeating behaviors and causes
depression, anxiety and eating disorders. It has been well studied and shown to be highly effective for treatment and prophylaxis
of depressive and anxiety disorders. It was modified for treatment of Bulimia Nervosa and more recently for Binge Eating disorder.
This includes a focus on normalizing food intake as well as challenging dysfunctional thinking, identifying feelings, and
developing non-food coping skills. It increases a sense of control and therefore helps the patient adhere to behavior change
strategy, as well as improving mood and reducing associated psychopathology.
The process can be divided into several
Involves developing a therapeutic relationship with the therapist and other group members
Getting to know
the nature of binge/emotional eating and factors thought to maintain the problem.
Keeping a diary for self- monitoring
of food intake, helps to identify the disordered eating, while working towards a normalization and structured or regular pattern
For post bariatric surgery patients, the focus is on the dietary adjustments, loss of their “friend”
food, their changed relationship to food, changes in their bodies and their relationships with others.
Identify and challenge maladaptive thoughts regarding eating and weight/ shape.
Identifies thoughts that are triggers
for binge/emotional eating.
Use cognitive restructuring techniques to normalize eating patterns.
For the post bariatric
surgery patient special attention is paid to body image and relationships. The rapid loss of weight post operatively can result
in disruption of the “homeostasis” of the relationship with their partner and result in relationship difficulties
Focuses on maintenance of change and relapse prevention
Identifying high risk situations
and developing a relapse plan.
The group usually works well with 6-8 patients meeting weekly and can last for 12 weeks with the
ability for patient to return if needed as well as additional individual therapy as needed.
This was initially
developed to treat depression, later modified for the treatment of bulimia nervosa and most recently for the treatment of
BED. IPT does not focus on eating behavior, but on relational factors associated with the onset and maintenance of binge eating.
It is based on the relationship between negative mood low self esteem traumatic life events, interpersonal functioning and
the patient’s eating behavior. The rationale being that eating represents maladaptive coping with underlying difficulties.
therapy has clear positive effects on behavioral and psychological features. Studies suggest that patients who are in remission
from binge eating achieve greater weight loss than those who are not in remission. It has been suggested that adding exercise
to CBT as well as extending the duration of treatment improves outcomes and reduces binge eating.
The key to maintaining
weight loss is the ability to continue a diet and exercise program “forever”. It is therefore best to adopt a
lifestyle change rather than diet for periods of time. Adding good eating habits and exercise and reducing abnormal eating
helps improve physical and mental health. The goal of CBT groups is to use cognitive exercises to change deeply ingrained
patterns of erroneous thoughts and behavior and thus setting the person free.