Obesity and Unorthodox Therapeutic Modalities


A meta study done by the United States Preventive Services Task Force (USPSTF) reviewed 45 trials of various behavioral interventions aimed at obesity. Together the studies encompassed more than 7,000 subjects. The very great majority of the studies, 42 of them, “used multicomponent interventions targeting lifestyle change.” Those components might include dietary counseling, exercise, and behavior change.

Then there were three studies that didn’t fit that category:

Three smaller trials assessed different behavioral approaches (weight loss maintenance, regulation of cues for overeating, and interpersonal therapy). IPT has been effective for use in individual and group formats and has demonstrated positive results for the prevention of excessive weight gain in overweight adolescents…

Interpersonal psychotherapy is the kind where the client learns to examine relationships with family and friends, and also learns ways to make changes in problem areas. It has short duration and a limited focus.

Here is an interesting thing about interpersonal therapy. Binge eating disorder and bulimia nervosa might, at first glance, appear to be very different maladies. After all, one leads to obesity, and the other emaciates. But interpersonal therapy has been named as one of the two most promising treatments for both conditions. (The other most promising treatment is Cognitive Behavioral Therapy.)

Here is an explanation of why interpersonal therapy seems to be effective:

IPT helps patients connect their binge and/or purge behaviors to interpersonal difficulties; the therapist highlights how a social arena can function as both a causal and a maintaining factor for binge eating, but can also be used as an avenue through which to build support for recovery. Given the emphasis of IPT on current relationships, it is particularly effective for youth, for whom the social network is of heightened importance.

Concerning obesity, binge eating disorder seems to fulfill the description of a Body Focused Repetitive Disorder, a type of problem which is also said to respond well to Cognitive Behavioral Therapy. We have discussed the probability that food addiction is a spectrum, with some victims more toward the substance addiction end and others toward the process addiction end. We explored Body Focused Repetitive Behaviors (BFRB) and mentioned that an institution called Visions Adolescent Treatment Centers named several therapeutic modalities that have been employed, with encouraging results, to deal with BFRB.

Some of the therapies are Cognitive Behavioral, Habit-Reversal, Acceptance and Commitment, and Dialectic Behavioral. Then there are Mindfulness, Interpersonal Effectiveness, Emotional Regulation, and Distress Tolerance.

As the old saying goes, different strokes for different folks. This is one of the advantages of human individuality — what doesn’t work for one person might very well work for the next. Childhood Obesity News has been looking at various unconventional ideas — for instance, the proposition that in certain cases, humor can be a food substitute. In the struggle against obesity, even marijuana has its supporters.

According to a two-minute video from High Times, the endocannabinoid system can influence appetite, metabolism, and weight. More recent studies have confirmed the beneficial effects, in terms of lowered BMI, reduced fat mass, and lower fasting insulin levels,
but the video was more fun.

Your responses and feedback are welcome!

Source: “Draft Recommendation Statement,” USPreventiveServicesTaskForce.org, November 2016
Source: “Binge Eating Disorder,” EdReferral.com, undated
Source: “Watch: How marijuana can help obesity,” HighTimes.com, 06/04/14
Source: “Marijuana, the Munchies and Obesity,” HighTimes.com, 08/26/15
Photo credit: symphony of love via Visualhunt/CC BY-SA

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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