Effective psychological and behavioural interventions in obesity management

RECOMMENDATIONS 1. The recommendations outlined below are summarised in the model presented in Fig. 1 and supported by the evidence summarised in Table 1. 2. Multi-component psychological interventions (combining behaviour modification [goal setting, self-monitoring, problem solving], cognitive therapy [reframing] and values-based strategies to alter nutrition and activity) should be incorporated into care plans for weight loss and improved health status and QoL (Level 1a, Grade A)[1-8] in a manner that promotes adherence, confidence and intrinsic motivation (Level 1b, Grade A). 3. HCPs should provide longitudinal care with consistent messaging to PLWO to support the development of confidence in overcoming barriers (self-efficacy) and intrinsic motivation (personal, meaningful reasons to change), to encourage the patient to set and sequence health goals that are realistic and achievable (Level 1a, Grade A), to self-monitor behaviour (Level 1a, Grade A), and to analyse setbacks using problem solving and adaptive thinking (cognitive reframing), including clarifying and reflecting on values-based behaviours (Level 1a, Grade A). 4. HCPs should ask patients' permission to educate them that success in obesity management is related to improved health, function and QoL resulting from achievable behavioural goals, and not the amount of weight loss (Level 1a, Grade A). 5. HCPs should provide follow-up sessions consistent with repetition and relevance to support the development of self-efficacy and intrinsic motivation. Once an agreement to pursue a behavioural path has been established (health behaviour and/or medication and/or surgical pathways), follow-up sessions should repeat the above messages in a fashion consistent with repetition (the provider role) and relevance (the patient role) to support the development of self-efficacy and intrinsic motivation (Level 1a, Grade A).