Cardiovascular diseases are amongst the most significant cause of adverse health effects and well-being of individuals. According to Public Health England, nearly two-thirds of the adult population is categorized as being overweight. Such a condition is as a result if having insulin resistance excess abdominal fat which is commonly referred to as the metabolic syndrome' and conveys the increased risk for Type II diabetes, obesity, high blood pressure and heart attack or stroke. As a result, interventions whose objective is to curtail the escalation of cardiovascular diseases often target the modifiable lifestyle behaviors of physical activity and dietary intake. Although some lifestyle interventions have yielded positive results in prompting behavioral alterations that have led to clinical improvements, there exists a wide variation regarding the efficacy of the approaches utilized especially in the long term. Moreover, there is the proposition that our ability to improve behavioral interventions is impeded by inadequacies in the rigor and detail in the intervention design and insufficient scrutiny of the mechanisms of behavior change. Consequently, this paper focuses on emphasizing the notion that personal behavior change is crucial to weight loss.
Challenges Associated with Dieting in Weight Loss
The intake of excessive calories is a unique health concern in the UK and other industrialized nations around the globe. Despite the proliferation of transportation mechanisms and sedentary occupations, adults are consuming more calories as compared to the previous years. Thus, conventional lifestyle weight management programs insist on promoting negative energy balance where individuals are encouraged to reduce their energy intake since caloric restriction has produced desirable results in weight loss (Goodpaster et al., 2010). Nonetheless, most individuals are unable to sustain weight losses that result from reductions in energy intake hence implying that long-term adherence to traditional approaches to weight loss is extremely poor. According to MacLean et al. (2010), some of the factors that directly influence long-term adherence to dieting practices are the prevalence of the seemingly toxic food environment in Europe which is characterized by inexpensive, easily accessible and integrates tasty high-fat, high-calorie foodstuffs. In such a situation, where healthy food menus are limited augment the challenge of maintaining dietary changes in the long-term (Thomas et al., 2014). Additionally, physiological changes are likely to occur during dieting where research demonstrates that individuals who are dieting develop greater sensitivity to palatable food, particularly salty and sweet substances (Johnston et al., 2014). Moreover, obese peoples have heightened sensitivity to the sensory processing of food intake which suggests that the rewarding properties of smell and taste lead to preference to foods high in fat and sugar including the tendency to overeat (Bacon and Aphramor, 2011). According to Sarwer, Dilks, and West-Smith (2011), the continued interaction of the aforementioned physiological changes combined with the continued exposure to harmful food environment virtually promises occasional lapses in dietary control.
Challenges Associated with Exercising in Weight Loss
As is the case with the interaction between environmental problems and a person that makes it hard to put up with healthy dietary changes, a collection of internal and external obstacles affects an individuals participation in regular exercise activities. The advent of technological innovation in industrial markets and agriculture has transformed jobs in European nations to become more sedentary where workers spend on average 6-8 hours sitting behind desks (Ho et al., 2013). As a result, compensation for the reduction in energy expended during working days is achieved by spending most of their leisure time attempting to meet national activity. According to Ebbeling et al. 2012 efforts geared towards scheduling exercises during limited leisure time coupled with competition from other lifestyle, activities lead to the apparent barrier of time constraints for most people. Moreover, other factors such as having more than one job, having to travel to recreational facilities and reliance on public transportation lead to the perceived lack of time. Blumenthal et al. 2010 argue that work stress is perhaps the most commonly identified barrier to achieving regular physical activity. Many individuals report being fatigued to participate in physical activity especially after returning home from an energy-draining and stressful workplace. Equally important is the fact that environmental limitations also represent a significant hurdle in the maintenance of the weight loss changes that arise from physical activity. Villareal et al. (2011) propose that People may experience difficulties in accessing areas designated for physical activity as most neighborhoods, especially low-income areas lack amenities such as bike paths, adequate sidewalks, and other recreational accommodations (Kitzmann and Beech, 2011). Indeed, there exists a high prospect that individuals may be physically active in areas with facilities such as tennis courts and parks which are located within the local area.
Theoretical Perspective on Adherence
The most fundamental theoretical perspective insofar as current lifestyle interventions are concerned is the social cognitive theory which provides an ideal structure through which elements that stimulate initiation and maintenance of behavior change can be comprehended (Spahn et al., 2010). Social cognitive theory denotes that personal factors such as emotions and cognitions combined with the physical and social environment influence behavior and how a person's behavior may have a reciprocal influence on these environmental and personal factors. The social cognitive theory integrates four sets of constructs regarding initiation and maintenance of behavioral alterations (Maddux and Kleiman, 2012). Health knowledge is one of the components which emphasizes a person's awareness of how their behavior may have an impact on their health. Self-efficacy principles and outcome expectancies pay attention to an individual's ability to assume particular behavioral patterns in a given situation and intensify the belief that the execution of such behavior will culminate in a specific outcome. Self-regulatory skills comprise of the expertise that allows a person exercise control over his environment, behavior or cognition (Annesi et al., 2011). Lastly, barriers to change integrate an individual's environmental or personal hurdle that may impede any activity directed towards performing a behavior.
Lifestyle interventions target all four constructs where health-related knowledge is reinforced by providing relevant information on the impact of physical activity and diet on risk for disease weight (Patrick and Williams, 2012). Self-efficacy beliefs and outcome expectancies are enriched through the use of a short-term, attainable goals that provide a sequence of successful experiences in altering exercise behavior and eating habits. Self-regulatory skills are augmented through the use of objective setting, stimulus control, written self-monitoring, self-reinforcement and cognitive restructuring strategies (Anderson-Bill, Winett, and Wojcik, 2011). The ability to overcome barriers to change may be dealt with through in-session problems solving and direct training in the proficiencies of problem-solving.
Promoting Long-term Adherence
Healthcare professionals play a crucial role in supporting healthy long-term behavioral changes in obese individuals. The provision of behavior-based weight management programs as early as possible serves as a pre-emptive measure of cardiovascular diseases progression while assisting an individual to make long-term behavioral changes (Hardcastle et al., 2013). Moreover, health care providers have the mandate of improving program implementation through the comprehension of the individual factors at play such as physical inactivity, parent's behavior and the related knowledge regarding healthy living. The utilization of motivational interviewing (MI) presents an evidence-based approach that providers use to assess an individual's disposition to change. The MI technique is a patient-centered, goal-oriented therapeutic intervention that was initially developed o be used amongst a population of substance user but has increasingly been applied as a standard measure to support the adherence to a variety of health behaviors (Miller, Marolen, and Beech, 2010). Without a doubt, MI allows aiding in the improvement of the individual's health knowledge and increasing self-efficacy for behavior change in a non-prescriptive and non-confrontational manner. The inaugural step involves the evaluation of the specific barriers to adherence. For instance, an obese person my state that the costs of exercising such as paying for membership outweigh the benefits gained which is improved health. The provider can then initiate a brainstorming session where additional benefits of exercise behavior may be identified such as improved mood, increased energy and weight maintenance which may encourage the individual to participate in exercise activities (Stewart and Fox, 2011). Equally important is the fact that health providers provide guidance on the process of listing the benefits and costs but not necessarily lecture the individuals on the reasons they believe the patient ought to change. This phenomenon may be based on the conception that the people are mostly influenced by ideologies and philosophies that are self-generated compared to those provided by external influences. Thus, the goal of such an intervention would be to increase the patient's motivation for behavior change by assisting him to recognize benefits of leading a healthy lifestyle change while diminishing the perceived costs.
The transition from initiation to long-term adherence to weight loss initiatives can be challenging to participants due to unprecedented obstacles. Accordingly, skills-training approaches have been incorporated to increase an individuals ability to navigate past the unexpected challenges that arise in pursuit of achieving a healthy lifestyle. One example is the relapse-prevention training which involves the identification of high-risk situations which might trigger lapses in adherence or successfully cope with such conditions if they begin to border on the extreme. Problem-solving skills training presents a structure for addressing barriers to change by sensitizing on the development of skills such as positive problem orientation; problem identification and definition; generation of alternatives; decision making; implementation and evaluation. A randomised control trial conducted by Perri demonstrated that the combination of extended care and problem-solving mechanisms resulted in a loss of an additional 1.5 kg in the year following the inception of the treatment as compared to a regain of 5.4 kg that was witnessed in participants in the control group (Mainwaring and Krasnow, 2010).
Application of Cognitive Therapy for Weight Loss and MB-EAT
Cognitive Therapy for Weight Loss presents a contemporary approach that employs the conventional principles of cognitive behavioral therapy where a person is engaged in planning what to eat, arranging the environment to support weight loss and prepare for high-risk situations including scheduling mealtimes and food shopping (Silva et al., 2010). Moreover, such a program involves referring to written weight loss goal cards while tackling counterproductive thoughts. Another approach is the use of Mindf...
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