Not only does the person get rid of their excess weight, but also the treatment of co-morbid diseases is provided. Intelligent exercise, massage, etc., especially disorders in the musculoskeletal system. With these applications, it is aimed to improve the general health of the person.
Content of the Program
This program; It includes the diagnosis, treatment and rehabilitation of obesity by following a multi-faceted holistic approach in order to treat and combat obesity.
To support healthy weight loss,
Reducing body fat rate,
To prevent further weight gain,
To eliminate the risks of other diseases associated with obesity,
To participate in more physical activity,
To gain healthy and balanced eating habits,
To increase the quality of life,
To recognize and change the psychological factors that cause obesity.
What is obesity?
Increasing obesity in the world is a serious chronic health problem. It causes deterioration of people’s health, quality of life and premature death. In clinical practice, body mass index (BMI) is generally used to determine the level of obesity. Body mass index (BMI) is calculated as body weight [kg] / height [m2].
According to the World Health Organization (WHO);
Overweight: BMI: 25.0-29.9 kg/m2,
Obesity: BMI ≥ 30 kg/m2 is accepted.
What are the diseases caused by obesity?
- Obesity also causes many diseases.These;
- type 2 diabetes,
- blood pressure diseases,
- Symptoms such as palpitations, shortness of breath,
- cardiovascular diseases,
- Musculoskeletal system diseases,
- Uterine, pelvic and intestinal diseases,
- It is sleep apnea.
What are the causes of obesity?
- genetic factors,
- slow metabolism,
- Wrong eating habits with high calorie and fat content,
- Sedentary lifestyle and lack of exercise
- Psychological or psychiatric causes.
In the treatment of obesity, it is aimed to get rid of excess weight in a holistic way, to maintain a healthy life, maintain weight and improve psychological resilience, together with a responsible physician, dietitian, clinical psychologist, and sports trainer who are experts in their field. The task of the dietitian is to change the nutritional habits, to choose foods with low fat and calorie ratios, and to reduce the portions. The task of the sports trainer is to prepare an exercise program suitable for the general body structure and health of the person. The task of the clinical psychologist is to find the underlying causes of the person’s inability to lose weight, to raise the awareness of the patient, to discover dysfunctional thinking errors and to make interventions to change them, to make individual interviews and group therapies to gain motivation.
METHODS OF TREATMENT
Nutrition Therapy: The basis of nutrition therapy is to provide adequate and balanced nutritional elements suitable for the individual’s age, gender, physical activity status, lifestyle and physiological state, and to gain correct and permanent nutritional habits instead of wrong eating habits. The daily energy intake of the individual should be reduced to ensure 0.5-1.0 kg weight loss per week. The individual should be weakened slowly and over a long period of time. The targeted level of body weight may be the ideal weight of the person or a body weight above the ideal weight. When the body weight reaches the targeted level, it is one of the most important goals to prevent weight gain and to keep it at the desired level.
Cognitive and Behavioral Therapy: In addition to physical activity and diet therapy, psychological therapies are also carried out together. An obesity treatment plan is prepared in cooperation with the patient’s motivation. Behavioral therapy is much more effective when it is supported by changing eating habits and group therapy. Behavioral approaches reported to be beneficial in the treatment of obesity include self-monitoring, stress management, stimulus control, problem-solving skills, self-reward, cognitive restructuring, and providing social support.
In self-monitoring, the patient is asked to monitor and record their behavior, such as calorie intake, exercise, or drug use, or their results. Thus, the patient becomes aware of the behaviors that cause obesity. For example, he becomes aware of his pathological conditions such as eating attacks, night eating, eating in times of nervousness-tension. In stimulus control, the patient is asked to identify the factors that trigger bad eating behavior, such as snacking while watching television, and to take them under control.
The past of obese patients is full of stories of unsuccessful diet and exercise attempts, inability to maintain the lost weight, disappointments, discrimination and labeling they are exposed to in their school, work and social lives. The patient must feel ready and motivated to participate in a weight loss program. To support an obese patient, review past success and failure stories.
It is necessary to learn well, to identify the source of the problems, to determine the factors that affect the eating behaviors, and then to reveal the methods that can solve all these problems. Among the most common reasons for their failure are setting unrealistic goals and not being aware of their wrong attitudes and behaviors.
Recognizing wrong behaviors with appropriate methods and methods that will provide permanent behavior change increase success. In this process, both the support of experts and the support of social and close circles are very important.
Group Therapies: In group therapies conducted with clinical psychologists, emphasis is placed on psychoeducation, self-esteem, body image, motivation, body-mind awareness, problem-solving skills, eating habits, reward-punishment systems, recognizing and expressing emotions. It is also supported by relaxation and breathing exercises.
Physical Exercise Therapy: Increasing physical activity is very important both in the treatment of obesity and in maintaining the lost weight. The contribution of physical activity alone to weight loss is not more than calorie restriction. However, increasing physical activity has many additional benefits besides weight loss, such as decreased visceral fat, increased muscle mass, decreased insulin resistance, and improved blood pressure and lipid profile. It has been shown that coronary artery disease and death rates are much lower in those who exercise regularly. Physical activity is also very important in terms of increasing one’s self-confidence and preventing weight regain. Suggestions for increasing physical activities must be individualized and their sustainability must be followed. Because physical activities can show great differences in line with the habits, socio-cultural characteristics and economic conditions of the patients. Walking is the easiest method among physical activities and the most comfortable method applied by everyone. It is also important to increase physical activity in harmony with daily life, such as using less vehicles, walking at a fast pace, not taking the elevator, and taking care to be with active / active people. At least 150 minutes of moderate-intensity exercise per week is recommended initially.
OBESITY AND PSYCHOLOGICAL FACTORS
There are many psychological factors underlying obesity. Emotions are primarily associated with obesity. Emotions greatly influence eating behavior. However, the effect varies from person to person. Some may increase their food intake when they cannot cope with their emotions, while others may decrease it. Eating behavior increases especially when feelings of sadness, stress and anger are felt. The person falls into a vicious circle. Being unhappy triggers the eating behavior and the person becomes more unhappy because of what he/she eats. For this reason, personal emotions are addressed and these negative emotions are addressed in individual interviews and group therapies.
In emotional eating, food is used to escape from negative emotions. Emotional eating causes obesity, eating disorders, and depression. Emotional eating has been observed especially in individuals with obesity. For this reason, the psychological treatment of obesity focuses on the effect of emotions on nutrition. It is very important to gain healthy and balanced eating habits in order to prevent emotional eating. In addition, regulating eating habits, gaining awareness, creating an emotion and food diary, and gaining exercise habits are also important parts of the treatment.
Individuals with obesity have a lack of self-confidence, feelings of worthlessness, difficulty in expressing themselves, problems with body image and self-esteem. Self-esteem is related to the individual’s realistic awareness and acceptance of his emotional, mental, physical and social characteristics. Thus, the individual does not love himself and sees himself weak. This causes depressed mood, depression, anxiety disorders and sleep problems.
Regarding the causes of obesity, the behavioral model argues that obesity is a learned condition with the use of inappropriate eating behaviors as reinforcement in order to reduce the negative emotions that cause discomfort in the person. The cognitive model, on the other hand, argues that the person has errors in information processing processes, thinking errors and dysfunctional beliefs. Thus, when the cognitive and behavioral model are taken together, the treatment of obesity focuses on thoughts, emotions, behaviors and social support.
PSYCHOLOGICAL TREATMENT OF OBESITY
Individuals with obesity have many unsuccessful weight loss attempts, disappointments, problems in their daily lives and deterioration in their functionality. First of all, it is very important that the individual is willing and ready for treatment. In the first stage, the patient’s past life, unsuccessful diet and exercise attempts, the underlying causes of the inability to lose weight.
reasons are well appreciated. In cooperation with the patient and the psychologist, they determine the wrong attitudes and behaviors of the patient and set a realistic target.
In the psychological treatment of obesity, it is aimed to change both thinking and behavior. There are self-monitoring in eating behavior, setting goals for changing habits, psychoeducation, raising awareness and awareness about the disease, encouraging to exercise, motivation, problem solving training, group therapies and individual interviews. It is tried to conceptualize the factors that initiate and maintain obesity and to replace these factors with more functional ones for permanent change. It is important to remove the barriers to weight loss.
One of the purposes is to enable the person to set realistic weight goals and make evaluations. As a result, it is the acquisition of skills to lose weight, keep it stable, and maintain weight while strengthening psychologically.