Research indicates that depression is a common occurrence amongst patients who have been diagnosed with obesity. Moreover, depression aggravates the condition of the patient by adversely affecting adherence to drug regimens, exercise and dietary recommendations which significantly affects patient's outcomes. Therapeutic interventions are perceived as the ideal approach for treating depression amongst somatic patient populations since it does impede the administration of pharmacological interventions, has no side effects and is often favored amongst patients in preference to antidepressants (Piet & Hougaard, 2011). Equally important is the fact that therapeutic interventions are recommended for treatment of depression as it equips the patients with coping mechanisms which offer support in the advent of future symptomologies of depression and in the long run diminish the risks associate with relapse.
Conventionally, Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Cognitive Theory (MBCT) have been actively incorporated in the treatment of co-occurring disorders obesity and depression. The fundamental principle for these acclaimed approaches inspires the awareness of thought and feelings so as sufficiently control them. Nonetheless, MBCT and CBT slightly differ in how it trains a patient to learn to gravitate towards desirable outcomes. In CBT, the primary constituents would comprise of behavioral activation and disparagingly challenge and substitute the content of harmful ideologies. On the other hand, MBCT is primarily concerned with teaching clients how to respond differently to depressive thoughts and feelings and thought including being more objective and non-judgmental towards these symptomologies (Segal, Williams, & Teasdale, 2012). In essence, MCBT is deemed as the gold standard for preventing the recurrence of depression amongst patients who are looking to make progress in the process of weight loss as a stratagem of curtailing the proliferation of obesity. Accordingly, this essay endeavors to highlight the efficacy of evidence-based practices of CBT and MBCT as they have been applied in the treatment of the obesity coupled with depressive symptomologies.
Challenges Associated With Dieting
The consumption of excess calories has emerged as a significant public health concern in the United States and other developed countries since it only serves to exacerbate the problem of obesity. The 21st Century has been characterized by the explosion of desk-bound occupations and development of transport mechanisms, and this phenomenon is compounded by the over-consumption of calories (Goodpaster et al., 2010). Accordingly, contemporary lifestyle weight management approaches advocate for the adoption of a negative energy balance where persons are encouraged to cut down on the levels of energy balance. This endorsement is by the widespread notion that caloric restriction culminates in positive results during the process of weight loss. More often than not, individuals who are an obese struggle with the sustenance of weight loss perhaps due to the prevalence of stigma and discrimination against such populations. Indeed, people who are regarded as being obese attract negative body image connotations where in extreme cases they are perceived as being fat, lazy and gluttonous. Such assumptions play a critical role in propagating and enhancing depressive symptomologies amongst individuals who are obese. In addition this, the prevalence if toxic food environment in the U.S has directly contributed to the lack of adherence to dieting practices. The popularity of high-fat, high-calorie foodstuff may be attributed to the inexpensive, availability and tasty nature of such menus. Equally important is the fact that physiological alterations is in the offing where research illustrates that individuals who are dieting develop cravings for tasty foods especially sweet and salty food stuffs (Armstrong et al., 2011). Furthermore, people who are obese experience intensified sensitivity towards the sensory processing of food intake. This implies that such individuals rely on the desirable properties of taste and smell culminating in the penchant for foods rich in sugar and fat. The continued interaction between exposure to seemingly harmful food environment and physiological alterations only serves to augment the possibilities of lapses in dietary regulation.
Challenges Associated With Exercising in Weight Loss
In addition to the evident interaction between environmental problems and physiological changes, an assortment of both external and internal impediments may interfere with a person's participation in activities incorporated in weight loss programs. The advent of agricultural revolution coupled with the expansion of technological innovations has morphed occupations into becoming more sedentary where workers in the modern world typically spend 6-8 hours sitting at the workplace. Further, the attempt to strike a balance between planned exercising activities and hobbies creates a time barrier for most individuals. Other factors that may interfere with exercising for weight loss purposes includes time spent traveling to and fro the recreational facilities; having more than one job and the overreliance on public transportation results in the perceived lack of time. Work stress has also emerged as a significant contributor to the barriers that prevent positive achievements in consistent physical activities (Appel et al., 2011). More often than not, people report of being extremely fatigued to participate in physical activities particularly when they return home from a stressful and energy-draining workplace. Research also posits that individuals may experience challenges in an attempt to access areas that are suitable for supporting physical activities within neighborhoods particularly in underserved communities which lack facilities such as ample side-walks, recreational accommodations and bike parks. Such amenities are parks, and tennis courts may serve as incentives for active participation in physical activities.
Theoretical Perspective on Adherence
The most basic theoretical viewpoint that is pertinent to the contemporary lifestyle interventions is the social cognitive theory which provides an appropriate design for spearheading components of maintenance and initiation of behavioral change that may be understood. This philosophy holds that personal factors such as cognition and emotions coupled with interactions with social and physical environment influences behavior and the outcome of behavior may create a mutual influence on these personal and environmental factors. The social cognitive theory incorporates four distinct constructs which are related to the inauguration and maintenance of behavioral modifications. The first standard is that of health knowledge which sensitizes on the need of a person's cognizance of the influence of their behavior on the health outcomes. Additionally, the self-efficacy principle and outcome prospects are mostly concerned with a person's capability to adopt certain behavioral patterns I a given situation including the intensification of the belied that undertaking such behavior would lead to a specific outcome. Self-regulatory proficiencies involves the know-how that enables an individual to assert control over his thought process, character, and environment. Equally important is the fact obstacles to change incorporate personal and environmental struggles that may limit any activities directed towards executing a particular behavior.
Interventions that touch on the lifestyle of individuals who are regarded as being obese involve all four principles above which focus on espousing health-related knowledge through the provision of the relevant information on the effect of lack physical activities and dieting on the risk of cardiovascular diseases. Self-efficacy notions and outcome anticipations are encouraged through the utilization of achievable goals in the short term to subsequently create a sequence of fruitful experiences which alter exercising and eating patterns. Self-regulatory skills are improved through the use of stimulus control, self-monitoring mechanisms, objective settings, and cognitive restructuring strategies. The ability to overcome hurdles that impede change may be addressed through in-session problem-solving techniques and direct training in the ability to solve problems.
Evidence-Based Practices for CBT
Cognitive Behavioral Theory (CBT) draws its philosophies from the widely acclaimed work of Albert Ellis and Aaron Beck where the former developed the Emotive Behavior Therapy (REBT) whose primary focus was to deal with issues related to behavioral and emotional problems. The underlying goal of the therapeutic intervention was to aid a client to desist irrational beliefs and progressively adopt more rational ones. In essence, REBT encourages an individual to distinguish general from irrational ideology and successively persuades the client to challenge the emerging false beliefs through the process of reality testing (Kennerley, Kirk & Westbrook, 2016). Furthermore, Ellis posits that every person possesses an exceptional collection of assumptions concerning themselves and their surrounding which serve offer guidance throughout the journey of life including the determination on a person's reactions when exposed to different situations. Regrettably, some people tend to possess assumptions which are mostly irrational and ultimately leads them to act in inappropriate ways which jeopardize their chances of success and happiness. Beck's perception of CBT is similar to Ellis' with the only exception his constructs are applied in cases of depression. The role of a therapist, in this case, would be to assist the client in recognizing that a negative stream of thoughts and errors in logic leads to depression. Moreover, the therapist helps the client question and challenge apparent dysfunctional beliefs and instead focus on applying alternative ways of contemplating their daily lives (Kahl, Winter & Schweiger, 2012). Equally important is the fact that CBT has two specific tasks which comprise of cognitive restructuring where the therapist works in collaboration with the with the client with the objective of altering the thinking patterns alongside behavioral activation where clients are taught how to overcome life challenges by participating in enjoyable activities. Essentially, CBT is more concerned with the condition, that is, the focus is on how and what a person thinks more than why a client takes a particular line of thought.
According to Gurman (2014), the Bowen's Family System Theory (BFST) framework presents a fundamental principle which sensitizes on the presumption that family may be considered as the primary unit upon which emotional interconnectedness occurs. In such an environment, the fabrics of fostered thoughts and feelings ensure the cohesiveness and support of each member and the inauguration of tense moments present strenuous relations. When a member of the family assumes an accommodating role, he is bound to be overwhelmed and isolated throughout the process. Subsequently, such an individual is prone to anxiety, depression, addictions and eating disorders (Jankowski & Hooper, 2012). In-Depth scrutiny of the above concept comprises of other principles such as employment of a three-pronged approach to dealing with individuals; the evaluation of the diversity of the susceptibility to pressures to conform to group norms; the utilization of the family projection and emotional system and the use of multigenerational transmission methodologies. The differentiation of self is the central conce...
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