Behavioral Weight Control Therapy with Children

Description of the Strategy

Lifestyle behavior modification for obesity is based upon changing eating habits and physical activity to yield negative energy balance, that is, burning more energy than is consumed via eating. During the initial phase of intervention, weight loss occurs at a rate of approximately 1 to 2 pounds (0.5 to 1 kg) per week and gradually tapers to a weight plateau. After this initial weight loss, the goal of treatment is weight maintenance, where the person learns to balance energy intake and energy expenditure.

There is a genetic component to the development of obesity. The interaction of genetics and environment may predispose selected persons to gain weight. Behavioral weight control is based upon basic laws of learning. Classical conditioning refers to the set of circumstances by which cues in an individual's environment become associated with a particular behavior. When an environmental stimulus is repeatedly paired with a behavior, the stimulus itself becomes a trigger to elicit a behavioral reaction. In the case of eating behavior, many aspects of the environment may become associated with hunger sensations and with eating. The smell or sight of food may become conditioned stimuli to eating and therefore trigger hunger [Page 743]sensations. This association is conditioned because the smell and sight of food are repeatedly paired with eating behavior. However, additional stimuli, when paired with eating, may become associated with feelings of hunger. If, for example, an individual habitually eats while watching television, then hunger sensations can be elicited by watching television. Behavioral treatment methods are designed to use the laws of learning to modify eating and exercise habits to produce negative energy balance, where more energy is expended through physical activity than is consumed via eating.