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Table 3 The main procedures of the six CBT-OB modules

From: Personalized cognitive-behavioural therapy for obesity (CBT-OB): theory, strategies and procedures

Module 1 - Monitoring food Intake, physical activity and body weight
• Initiating weekly weighing
• Explaining what the treatment will involve
• Educating on energy balance
• Establishing real-time monitoring of food intake and physical activity
• Initiating weekly weighing
Module 2 - Changing eating
• Creating an energy deficit of 500–1000 kcal per day produce a variable weight loss of about 0.5–1 kg a week.
• Planning ahead when, what and where to eat
• Eating consciously
Module 3 - Developing an active lifestyle
• Assessing the patient’s eligibility for exercise
• Assessing the patient’s functional exercise capacity
• Motivating the patient to exercise
• Developing an active lifestyle, reducing sedentary activities and increasing the daily step count
• Improving physical fitness
• Continuing or commencing formal exercise (in selected cases)
Module 4 - Addressing obstacles to weight loss
• Educating the patients on cognitive-behavioural weight-loss obstacles (antecedent stimuli, positive consequences, problematic thoughts)
• Introducing the Weight-Loss Obstacles Questionnaire
• Creating the Personal Formulation
• Addressing weight-loss obstacles
- Reducing environmental stimuli
- Addressing events influencing eating and exercise habits
- Addressing impulses and emotions influencing eating and exercise habits
- Addressing problematic thoughts
- Addressing the use of food as a reward, and the patient’s rational excuses for not adopting an active lifestyle
Module 5 - Addressing weight-loss dissatisfaction
• Detecting weight-loss dissatisfaction and its reasons
• Addressing unrealistic weight goals
• Addressing dysfunctional primary goals for losing weight
• Addressing negative body image
Module 6: Addressing the obstacles to weight maintenance
• Reviewing the changes achieved through weight loss
• Educating the patient on weight maintenance
• Involving the patient actively in the decision to start weight maintenance
• Introducing the procedures for weight maintenance
- Establishing weekly self-weighing and a weight-maintenance range
- Adopting eating habits and physical activity habits conducive to weight maintenance
- Constructing a weight-maintenance mindset
- Identifying and addressing high-risk situations and
- Addressing weight regain
• Discontinuing real-time monitoring of food intake
• Evaluating possible future weight-loss attempts
• Preparing a weight-maintenance plan
• Bringing the treatment to a close