In 2005 I (further) infuriated my “weightloss lecturer” on a reps accredited weight management course by actually buying my own (expensive copy) of ‘cognitive behavioural treatment of obesity” by Cooper et al., and the “Handbook of Obesity Treatment” edited by Wadden and Stunkard. At that time, Cognitive Behavioural Therapy (CBT), in obesity treatment, reigned supreme.
It was the antidote to “insane” and “improper “diet regimes like the zone, paleo, atkins etc. According to the commentators and dietians, the food pyramid combined with CBT, would do the trick. In all fairness it was the “new” government pyramid that actually suggested that refined sugar was “not so good”. A few years before, anyone daring to suggest that Carb was not God was pilloried as a charlton.
CBT treatments (BTW)
1) are based on a cognitive conceptualization of the processes that maintain the problem
2) are designed to modify maintaining mechanisms, the predication being that this is necessary for there to be lasting chane
3) use a combination of cognitives and behavioural procedures to help the patient identify and change the targeted maintaining mechanism
Anyway, thank God for long term studies. according to Zafra Cooper in
“Testing a new cognitive behavioural treatment for obesity: A randomized controlled trial with three-year follow-up” “featured in Behav Res Ther. 2010 August; 48(8): 706–713.)
“Two main conclusions may be drawn from the findings. Neither is new. The first is that among people with obesity it is remarkably difficult to maintain a new lower weight following weight loss. It can be done (Ikeda et al., 2005; Wing & Phelan, 2005) but it is not common. The reasons for this are not known. It is possible that the processes specified by the CBT theory do indeed operate but that our treatment was not sufficiently effective at changing them. Thus it is not possible to determine from this study whether the theory is incorrect or whether CBT was not sufficiently potent. Alternatively or additionally, other processes may be largely responsible for weight regain.
The second conclusion has far-reaching implications. It stems from the finding that sustained behaviour change in people with obesity is remarkably difficult to achieve, unlike the situation with people with eating disorders (e.g., Fairburn et al., 2009). This is a sufficiently robust finding to make it ethically questionable to claim that psychological treatments for obesity “work” in the absence of data on their longer-term outcome. A further implication is that psychosocial research on obesity should perhaps shift away from work on treatment and instead focus on prevention”
Wow. Its all crap!
Its good though to look at the escalating endorsement of low carb approaches; look at Foster et al, Ann Intern Med. 2010 Aug 3;153(3):147-57. “Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial” which concluded
“Successful weight loss can be achieved with either a low-fat or low-carbohydrate diet when coupled with behavioral treatment. A low-carbohydrate diet is associated with favorable changes in cardiovascular disease risk factors at 2 years”
Keep an eye out as Crossfit London starts its process of reviewing and assessing obesity treatments that work. we will be needing volunteers to trial approaches, so, if you are interested in being a part time guinea pig drop me or kate an email.