treatment of childhood & adolescent obesity: expert recommendations & the emergence of...
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Treatment of Childhood & Adolescent Obesity: Expert Recommendations & the Emergence of Immersion & Healthy ObsessionsDaniel Kirschenbaum, Ph.D., ABPP
04/15/23 RiverMend Health, LLC 2
Explanations for Immersion-CBT’s Effectiveness
2007 Healthcare Organizations’Four Stage Model
ExpertRecommendations
Self-help Groups
ClientBehaviors& Biology
OVERWEIGHT
OutpatientCognitive-Behavior
Therapy (CBT)
Bariatric Surgery
Immersion CBT
Healthcare Providers:Medical Management,Education & Referral
Specialists:
ExpertRecommendations
Specialists:
Self-help Groups
ClientBehaviors& Biology
OVERWEIGHT
OutpatientCognitive-Behavior
Therapy (CBT)
Bariatric Surgery
Immersion CBT
Healthcare Providers:Medical Management,Education & Referral
ExpertRecommendations
Specialists:
Self-help Groups
ClientBehaviors& Biology
OVERWEIGHT
OutpatientCognitive-Behavior
Therapy (CBT)
Bariatric Surgery
Immersion CBT
Healthcare Providers:Medical Management,Education & Referral
Specialists:
ExpertRecommendations
Specialists:
Self-help Groups
ClientBehaviors& Biology
OVERWEIGHT
OutpatientCognitive-Behavior
Therapy (CBT)
Bariatric Surgery
Immersion CBT
Healthcare Providers:Medical Management,Education & Referral
• ALL endorsed intensive CBT• 2 most recent: de-emphasized EDUCATION• Step models seem best, most inclusive – and emphasis on sustained efforts for > outcomes
Specialists:
• ALL endorsed intensive CBT• 2 most recent: de-emphasized EDUCATION• Step models seem best, most inclusive – and emphasis on sustained efforts for >
outcomes
Explanations for Immersion-CBT’s Effectiveness
Per
cen
t O
verw
eig
ht
Treatment Begins
+10
-20
0
-10
-30
Follow-up
Education & Controls
OutpatientCognitive-Behavior
Therapy (CBT)
ImmersionNon-CBT
ImmersionCBT
From Kelly & Kirschenbaum (2011). Obesity Reviews.
• Obesogenic Environment: Removed
• Greater Intensity: Therapy, Education
• Increased Power: More Modeling & Support
• Momentum: Faster, More Dramatic > Motivation
• Family Support – Increased (momentum again)
Obesogenic Environment: Removed
Greater Intensity: Therapy, Education
Increased Power: More Modeling & Support
Momentum: Faster, More Dramatic > Motivation
Family Support – Increased (momentum again)
Lifestyle ChangeHealthy
Obsession
Rapid Consistent
Weight Loss
Cognitive-Behavior Therapy
Immersion Treatment
Social Support