Cognitive Remediation Therapy for Obesity

20 January, 2020
In this article, we'll be talking about the link between obesity and executive functions. Cognitive remediation therapy for obesity uses this link and can provide valuable help to sufferers.
 

This is a historic period of time in which society is paying more attention than ever to the body and nutrition. Nevertheless, the number of people who are obese or overweight continues to rise all over the world. Dieting and exercise programs often seem to fail in the long term. Cognitive remediation therapy might be the solution to this issue.

The fitness of this therapy as a fundamental element in the management of obesity is due to its ability to improve executive function. Current research shows that those who suffer from obesity have difficulties making good decisions in certain areas. For example, they might find it difficult to make good health decisions. This may be because their executive functions are different from those of the non-obese.

Experts haven’t yet identified the source of the executive profile of people with obesity. Nevertheless, there is, unquestionably, a bidirectional link between changes in executive functions and obesity:

  • People who suffer from obesity have abnormalities in their metabolism related to glucose and cellular inflammation. These negatively impact executive functions.
  • Likewise, researchers have found that obese people have higher stress levels. These are also related with changes in these functions.
  • At the same time, the change in executive functions generates more obesity. That’s because it makes it more difficult to make optimal decisions on the quantity and quality of the food they eat. They also find it difficult to control when they eat.

These points demand a way of dealing with the issue that essentially goes beyond conventional methods. Some examples of such conventional methods are dieting and physical exercise. This is where cognitive remediation therapy can contribute significantly to therapeutic goals.

 
A woman using cognitive remediation therapy to deal with thoughts that encourage bad habits.

Cognitive remediation therapy

Cognitive remediation therapy comprises psychological interventions based on mental exercises. The goal is to improve cognitive strategies, thinking, and information processing skills. You can accomplish this through consistent practice with its techniques.

This therapy stimulates reflection on your own thoughts. Its proponents argue that this gives way to healthier behaviors. Thus, its main goal is to specifically reinforce altered cognitive capabilities.

In the case of obesity, people must direct cognitive remediation toward improving executive functions.

Cognitive remediation therapy for obesity

Cognitive remediation therapy for obesity (CRT-O) is a face-to-face treatment. Its goal is to optimize executive functioning. This, they say, can improve peoples’ thought patterns regarding eating and exercise habits. The goal is to achieve a healthy lifestyle.

CRT-O was designed to provide obese individuals tools to help them think differently. It consists of a series of mental exercises that improve cognitive strategies. They do this through the practice of information processes and skills.

 

Research shows that “weight loss” programs that include CRT-O get better results. That means that there’s more weight loss, a healthier lifestyle, and less binging. People who engage in this therapy also experience a higher quality of life and a reduction in inflammatory factors.

Various studies suggest that CRT-O can improve weight loss, even when patients don’t exercise nor diet. Of course, the results in this case usually aren’t as good as those of people who do. In the rest of the article, we’ll show you some activities you can use to train your executive functioning.

Obese people have altered cognitive processes regarding many elements in their lives. Some examples of these are: inhibitory control, working memory, flexibility of thinking, and central consistency.

Activities that can improve your inhibitory control

Inhibitory control refers to a person’s capacity to inhibit automatic responses. Thus, it allows them to generate other responses that attention and reasoning modify.

Gaining greater inhibitory control requires you to avoid intended behaviors, first and foremost. Then, you’re supposed to reflect on the thought that’s leading to the behavior. The goal is for you to become conscious of your own thoughts. Then, you can analyze them before going through with the action that the thought is encouraging.

Perhaps it might be best to give you an example. Say you’ve finished eating dinner and you suddenly get the irresistible urge to eat candy. Before going to fetch it, you should reflect on the content and meaning of your own thoughts:

 
  • Why do I have to eat candy?
  • Is it hunger?
  • Could it also be that I didn’t eat enough carbohydrates?
  • Am I trying to regulate one of my emotions? Which one? Does this really help me? Do I need to eliminate something?
  • Will I be better off after having eaten the candy?
  • What are the possible consequences of this behavior?
  • Can I do something else to feel better?

Training inhibitory control requires you to introduce a thinking phase between the thought’s appearance and your behavior.

Interventions to improve working memory

Working memory refers to a person’s ability to remember the necessary things to do a specific action.

Comprehension and experiencing are perhaps the best tools for improving your memory. That’s why it’s essential for patients to understand the reason for each intervention. They should also participate in strategy development, as well as experiment with and adapt to changes in their own lives.

An obese man sitting on a bed.

Activities for training cognitive flexibility

The term “cognitive flexibility” refers to a person’s ability to modulate their thoughts and actions in certain situations. It refers specifically to situations that may be novel, constantly changing, or unexpected.

 

In order to train cognitive flexibility, you have to learn to face old situations with new tools. The goal is also to force your brain to develop alternate strategies for getting a specific goal.

Some good examples of this are: using different routes to get to work or changing the order of your morning routine. You might talk about a work project to an acquaintance in your own words. Meeting new people is also a way to do this. For a more specific activity, you could try out adhering to your eating plan in different environments (work, restaurants, at home, etc.).

Another example related to eating could be working on an open eating plan. In this exercise, you have to combine types of foods.

Training central consistency

You might define central consistency as the capacity to provide a complete and realistic perspective of a particular situation. During the consultation, it’s also a good idea to reason through situations of conflict out loud. You should also keep the context and all of the related ideas as a whole in mind.

In the same way, it’s a good idea to ask for a brief summary after a complicated detail-rich reading. This could be a verbal or written summary. So consequently, this can contribute to improving the capacity for developing and understanding a general idea without going into detail.

Without a doubt, cognitive remediation therapy is a critical tool for improving your executive thinking abilities. This is especially true for people who suffer from obesity. It might even help them manage their condition effectively in the long term.

 

Hilbert, A., Blume, M., Petroff, D., Neuhaus, P., Smith, E., Hay, P.J. & Hüber, C. (2018). Group cognitive remediation therapy for adults with obesity prior to behavioural weight loss treatment: study protocol for a randomised controlled superiority study (CRT study). BMJ open, 8(9). Consultado el 31/10/2019. Recuperado de: https://www.ncbi.nlm.nih.gov/pubmed/30224391

Raman, J., Hay, P., Tchanturia, K. & Smit, E. (2018). A randomised controlled trial of manualized cognitive remediation therapy in adult obesity. Appetite, 123: 269-279. Consultado el 31/10/2019. Recuperado de: https://www.ncbi.nlm.nih.gov/pubmed/29278718

Segura, M., Roncero, M., Oltra Cucarella, J., Blasco, L., Ciscar, S., Portillo, M., Malea, A., Espert, R. & Perpiñà, C. (2017). Entrenamiento en remediación cognitiva y habilidades emocionales en formato grupal para pacientes con obesidad: un estudio piloto. Revista de Psicopatología y Psicología clínica, 22(2): 127-138. Consultado el 31/10/2019. Recuperado de:  http://revistas.uned.es/index.php/RPPC/article/view/19115

Smith, E. & Whittingham, C. (2017). Cognitive remediation therapy plus behavioural weight loss compared to behavioural weight loss alone for obesity: study protocol for a randomised controlled trial. Trials, 18(42). Consultado el 31/10/2019. Recuperado de: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5270361/