Nutritional Education and Exercise Treatment Based on Cognitive Behavioral Treatment in the Saku Control Obesity Program (SCOP)

Abstract

BACKGROUND: Long-term weight loss is difficult to maintain, but recently cognitive behavioral therapy has been shown to be effective for long-term weight loss and maintenance. METHODS:The 119 participants, who had been assigned to program to lose weight, were interviewed by dieticians regarding their motivation for weight loss and psychological status and self-corrected problems with their eating activities and exercises, following recognition of problems, discussing solutions, and devising personal dietary plans and exercise plan to loose weight at 1.0-2.0 kg per month. RESULTS: In women, the prevalence of motivation to resolve the situation (n = 44, 84.6%) was significantly higher than that of men (n = 33, 67.3%; p < 0.05). In men, awareness of the need to keep healthy by oneself was significantly associated with the motivation to resolve the situation (p = 0.002) and the availability of support from others (p = 0.004). Thirty problems and 29 dietary goals were set by participants. The percentages of intake of alcohol (p < 0.05) and intake of sweets (p < 0.01) as the problems and decrease of intake in specified foods (p < 0.01) and snacks (p = 0.05) as dietary goals were significantly different between men and women. Women with BMI over 31 kg/m 2 set fewer additional steps as exercise goals than those with BMI under 29 kg/m 2 (p < 0.05). CONCLUSIONS:The characters of subjects such as psychological status and the problems and the target recognized by participants were different between gender and the degree of obesity.Obesity is increasing in prevalence in Japan, and it represents a major risk not only for metabolic syndromes, such as type 2 diabetes, ischemic heart disease, hypertension, gout, and dyslipidemias, but also some cancers.1) Loss of 10% of starting weight is thought to be associated with amelioration of risk factors such as hypertension, hypercholesterolemia, and hyperglycemia.2) Traditional dietary treatment of obesity consists of an energy-reduced diet prescribed by dietitians to achieve weight loss in a short period. 3) Long term evaluations of obesity interventions indicate that weight loss accomplished through changes in diet and physical activity is rarely maintained. 4) Since Stuart first applied behavior therapy to weight loss in the obese, 5) more than 100 papers have been published in the field. The goal of behavioral treatment is for participants themselves to choose to reduce caloric intake and increase energy expenditures based on alternatives provided by professionals, such as the dietitians.Recently, cognitive behavioral treatment has been applied to weight loss in the obese. Cognitive behavioral treatment (therapy) is a methodology for systematically modifying eating and activity habits, other behaviors, or negative thoughts that appear to contribute to obesity using a combination of selfmonitoring, goal setting, stimulus control, cognitive restructuring, stress management, and social support. The cognitive behavioral treatment can be applied in an individual or group setting to a...

Changes of Fat Volume and Adipocytokines by the Randomized Intervention Program for Obesity Control Program (SCOP)

“…During the intervention, energy source, crops and diary decreased, while the intake of green yellow vegetables increased. 27 Eating speed improved and physical activity also increased compared to the control group. 32 Especially in Group A, women increased their daily physical activity and improved their irregular eating habits during the follow-up period.…”

“…The integrative interventions have been reported in detail previously. [23][24][25][26][27][28][29][30][31][32] Group A participants were followed for two years after one year intervention, without any period. Clinical and biological parameters were assessed at baseline (0 month), after the end of intervention (12 month) and during the follow-up (24 month) ( Figure 1).…”

“…[23][24][25][26][27][28][29][30][31][32] The program was conducted at the Saku Central Hospital Human Dock Center from July, 2006. The participants received individual counseling (30 minutes) from a registered dietician, and group sessions about effective physical activity (20 minutes) by exercise instructors.…”