Obesity Counseling Should Stress Brain, Not Willpower: Study

Telling patients they're overweight because they lack self-control will backfire, researchers say

WEDNESDAY, Aug. 3, 2011 (HealthDay News) -- Obesity counseling should focus on neurobehavioral processes -- the ways the brain controls eating behavior in response to biological and environmental factors -- instead of personal choice and willpower, researchers suggest.

The team at Rush University Medical Center in Chicago outlines their new counseling approach in the August issue of the Journal of the American Dietetic Association.

"Typically, overweight and obese patients receive education about dietary contributions to weight gain, and they are simply encouraged to fight the powerful urge to eat the delicious foods that are available almost everywhere in the environment, and instead, make dietary choices consistent with weight loss," lead author Brad Appelhans, a clinical psychologist and obesity researcher, said in a university news release.

"Yet, we know this approach rarely works. Even highly motivated and nutritionally informed patients struggle to refrain from highly palatable foods that are high in sugar, salt and unhealthy fats," Appelhans continued.

Telling patients that their obesity is caused by unhealthy personal choices or lack of willpower can be stigmatizing and is unlikely to motivate them to lose weight, he added.

The new model for obesity counseling focuses on three neurobehavioral processes consistently linked to obesity and overeating -- food reward, inhibitory control and time discounting.

Food reward refers to the pleasure a person receives from eating and the desire to eat sweet and fatty foods. Inhibitory control refers to the ability to suppress urges to eat high-calorie foods. Time discounting refers to the human tendency to choose the immediate pleasure from eating over the delayed health benefits of weight loss.

Strategies that the researchers recommend include removing high-fat foods from your home and workplace; shopping for groceries online or with a grocery list; practicing stress management to limit emotional eating; and avoiding challenging situations such as restaurants and buffets.

Also, set short-term behavioral goals, such as preparing healthy meals several nights a week, instead of concentrating on long-term weight loss, they advised.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases offers advice about weight loss for life.

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