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The Site for Professionals interested in learning more about working with the obese from a psychophysiological perspective.
Introducing Dr Blair-West's work & his workshops: Understanding the Psychology & Sabotage of Weight Loss — Deconstructing Motivation
The evidence-based imperative to ensure best practice
Only 13%-20% of those who intentionally try to lose weight are able to lose 5% of their body weight and maintain this for 5 years. [1] In the face of the obesity epidemic, these concerning outcome data demand a fundamental reconstruction of extant approaches to managing obesity to ensure they align with best practice. The research is clear - the therapeutic focus needs to shift from a 'willpower driven' focus on weight loss to a psychologically sophisticated focus on long term lifestyle change.
Psychologically focussed treatment with a longer term follow-up maintenance phase is now considered the standard for treating obesity.[2] The exhaustive Cochrane treatment review found that increasing the intensity and duration of the psychological intervention significantly increased the weight reduction.[3] Specifically, group therapy has proven to be not only the more cost-effective face-to-face modality, but an equally effective (if not more effective) intervention for treating obesity and maintaining weight loss. One of the counter-intuitive findings is that those who prefer individual treatment actually do better in group therapy than those who prefer group over individual work.[4]
A recent survey of 200 UK GPs found that 'lack of patient motivation' was the top barrier to weight loss.[5] Behavioural factors were consistently ranked as more significant than non-behavioural factors such as lack of nutritional knowledge or insufficient support from health professionals. While 93% of GPs saw behavioural change as 'very important', only 19% reported providing behavioural treatments to their patients. Only 1% felt they were successful in supporting their patients weight loss attempts. They cited a lack of resources and funding as reasons for not providing behavioural intervention.
Dr Blair-West's clinical focus - 'Behavioural Fatigue' and Sabotage
Dr George Blair-West is a medico and psychiatrist who specialises in the psychotherapy of weight loss. His preferred mode of psychotherapy is group therapy. His workshops are designed to train participants in the most practical elements of the clinical treatment of obesity with a higher order focus on two emerging problem areas - 'behavioural fatigue' and weight loss sabotage by self and others.
Behavioural fatigue relates to the problem of the people in the maintenance phase of weight loss tiring of restricting their food intake and exercising vigorously.[2] The issue of 'restriction' is the domain of Restraint Theory and the wealth of research[6] into this fascinating world. The workshop will look at what Restraint Theory has to teach us about dealing with the problem of people tiring of restricting. Strategies for dealing with motivation and exercise will also be addressed.
A disturbing 69% of people on a bariatric surgery waiting list have a history of childhood abuse.[7] This population often use their weight as a form of protection and will sabotage their weight loss if these underlying issues are not addressed. With his extensive experience in also treating trauma, Dr Blair-West has a particular interest in identifying common forms of sabotage, by self and others, and treating these problems very specifically.
While Dr Blair-West has a background in research and completed a three year tenure as a Senior Clinical Lecturer at the University of Queensland, his real interest is in teaching clinical skills. After reviewing the background research, this workshop will teach you hands-on skills. You will leave with new techniques and strategies - that you can use the very next day - for working with the obese.
The 2 Day Workshop will answer the following questions:
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Why do traditional weight loss approaches have an 80% failure rate?
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What are the necessary behavioural & psychological requirements for weight loss?
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Which proven psychotherapeutic approaches are most relevant to dealing with weight loss?
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What are the most common forms of self-sabotage?
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What is 'motivation' & why is the amount of dietary self-discipline required a marker of failure?
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What is Restraint Theory & how does recent research predict dietary sabotage?
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How do I discover & mobilise motivation?
Over the last 7 years, in developing a psychotherapy of weight loss, Dr Blair-West, has been 'diligently stealing' from, and integrating, a range of approaches including relapse prevention, psychodynamic, existential & mindfullness-based schools of therapy.
A psychotherapist with 20 years experience, as well as various keynotes, he was invited to present his work that is all about addressing behavioural fatigue at the 2006 International Congress on Obesity.
For further information, to book & for dates of regionial workshops browse this site and register online.
If you are interested in co-ordinating a workshop in your city email Dr Blair-West
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REFERENCES 1 Wing RR & Phelan S. Long-term weight loss maintenance, Am J Clin Nutr 2005;82(suppl):222S–5S.
2 Wadden TA, Butryn ML, & Byrne KJ. Efficacy of lifestyle modification for long-term weight control. Obes Res. 2004;12:151S–162S.
3 Shaw K, O'Rourke P, Del Mar C, Kenardy J. Psychological interventions for overweight or obesity. The Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD003818.pub2. DOI: 10.1002/14651858.CD003818.pub2.
4 Renjilian DA, Perri MG, Nezu AM, McKelvey WF, Shermer RL, Anton SD. Individual versus group therapy for obesity: effects of matching participants to their treatment preferences. J Consult Clin Psychol. 2001;69:717–21.
5 Survey of 202 UK-based General Practitioners conducted by Taylor Nelson. www.medicalnewstoday.com/articles/76504.php
6 Ogden J. The Psychology of Eating 2003, Blackwell Publishing, Oxford.
7 Grilo et al. Childhood maltreatment in extremely obese male and female bariatric surgery candidates. Obes Res. 2005;13:123–130. Click here to download this paper |
