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Be h avioral Dietary Training

This article discusses the reasons behind tiredness and the importance of behavioral dietary training in increasing energy levels. It provides practical tips and strategies to help patients overcome fatigue and improve overall well-being.

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Be h avioral Dietary Training

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  1. Why am I so tired? Think I need an energy drink. Behavioral Dietary Training Why don’t patients listen? Charles F. Lorbeer, Ph.D., LICSW, MSW UF Health Psychiatry & CHFM

  2. Disclosures None

  3. Make it simple- create a metaphor Eat this now!

  4. Consequence- carry this all day long

  5. Who wants what? Doctors want to educate: What patients’ want:

  6. Appetite Defined A desire or motive derived from a biologic or psychological need for food, water, sex, or affection: a desire or longing to satisfy any conscious physical or mental need. Stedman’s Medical Dictionary, 2013, p. 124 It’s just one nugget

  7. Weight & Appetite: The Brain Circuits The same pathways that mediate interest and pleasure may be involved in regulation of weight and appetite. Abnormalities in hypothalamic pathways may lead to changes in weight or appetite. “It is apparent that simply knowing that a healthy diet and exercise will result in weight loss is not sufficient to reach and maintain a healthy lifestyle and reduce excess body weight. Behavior patterns are a fundamental contributor to the etiology of obesity and, therefore, behavioral therapyis often a key part of the management of obese individuals. A proportion of obese individuals do successfully maintain weight loss and this is associated with specific changes in behavior, particularly with regard to diet and exercise.   Greenway, F. 2015, p. 1190

  8. Homoeostatic, environmental and behavioral factors Factors affecting energy balance and thus steady-state weight. These three factors interact and influence steady-state body weight. Alterations in any of these factors will result in changes to this steady-state and could result in obesity (Greenway, F. 2015, p. 1189). . Greenway, F. 2015, p. 1190

  9. % of Obese Americans CDC Behavioral Risk Factor Surveillance System. Retrieved March 13, 2017, from https://www.cdc.gov/brfss

  10. Obese Adult Population CDC Behavioral Risk Factor Surveillance System. Retrieved March 13, 2017, from https://www.cdc.gov/brfss

  11. Exercise & Diet Doctors tell patients: Decrease intake, increase activity! Regular exercise helps relieve symptoms of depression and anxiety. Lower calories, lower sodium, lower fat, more fiber, etc. Why don’t patients listen??? Just a small snack won’t hurt

  12. Make it simple- create a metaphor Analogy and metaphors are powerful tools- Why are they so powerful for patient education? • Analogy and metaphor are figures of speech that have been used since the time of Aristotle and Plato. • Because analogy and metaphor can make abstract concepts real, helping patients understand why they are ill and how suggested changes will help correct underlying causes. • Analogy and metaphor create a form of cognitive “scaffolding” on which patients can hook new material to information they already understand.

  13. A Bowling ball is 12 pounds

  14. How many bowling balls?

  15. Deceptive Tactics “It is very unlikely that our obesity-promoting environment will change in the near future. It is therefore mandatory to improve our knowledge of the main factors associated with successful adoption of obesity-reducing behaviors. This may help design more powerful procedures and strategies to facilitate the adoption of healthy lifestyles in a "toxic" environment favoring the development of a positive energy balance. (Reggiani, et al, 2013, p. 101). Food makers do not completely appreciate the neuroscience of the forces they have unleashed, but they do recognize human behavior, taste inclinations and craving… food makers control ingredients to obtain the ‘bliss point’ of foods so that they obtain the exact peak at which we gain the maximum gratification from sugar, fat and salt. former FDA Commissioner Dr. David A. Kessler, The End of Overeating: Taking Control of the Insatiable American Appetite, Macmillan Publishers, 2009. 1994 survey: the standard plate size in the restaurant industry grew in the early 1990s, from 10 inches to 12. Holds 25% more food 2003 study: 20% more cornflakes/milk per serving than 1984 Glass of orange juice grew by more than 40 percent compared to 20 years ago. 50 additional calories, or a weight gain of 5 pounds over the course of a year, if consumed on a daily basis.

  16. Deceptive Tactics

  17. Handouts from the Albert Ellis Institute- www.rebt.org (Bernard & Wolfe, 2000. Used by permission)

  18. Portion Control

  19. But I just had 2 drinks…..

  20. Consequence- carry this all day long

  21. Is it worth me carrying a sack of bowling balls the rest of my life?

  22. Celebrate Success!!!

  23. References: • Bernard, M. E., & Wolfe, J. L. (2000). The REBT resource book for practitioners: innovative REBT techniques for practitioners with reproducible self-help articles and handouts for clients. New York: Albert Ellis Institute. • Beitz, J. Power up your patient education with analogies and metaphors. (2013, September 25). Retrieved April 14, 2017, from https://woundcareadvisor.com/power-up-your-patient-education-with-analogies-and-metaphors_vol2-no5/ • Greenberg, J. A. (2013). Obesity and early mortality in the United States. Obesity,21(2), 405-412. • Greenway, F. L. (2015). Physiological adaptations to weight loss and factors favoring weight regain. International Journal of Obesity,39(8), 1188-1196.  • Lefevre, M. L. (2014). Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine,161(8), 587. doi:10.7326/m14-1796 • Masukume, G., & Zumla, A. (2012). Analogies and metaphors in clinical medicine. Clinical Medicine, 12(1), 55-56. • Stedman's Medical Dictionary North American Edition. (2013). Lippincott Williams & Wilkins. Contact: clorbeer@Comcast.net

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