Its emergence can be explained using the principles of learning (processes of classical and operant conditioning) and cognitive theories. There are three main models of learning on which CBT methods are based: 1. Classical conditioning. This model includes methods based on learning and identifying the connection between stimulus and response. Classical conditioning: stimulus (hunger) -> response (I eat). If natural signals of hunger and thirst functioned as exciters, and we would not eat food when In other circumstances, the problem of obesity would not have arisen. These signals have unfortunately disappeared over the lifespan of obese people. Regardless of hunger, obese people are unable to predict what portion of food is normal and natural. They do not eat based on physiological needs, but food intake is triggered by other stimuli. Just as Pavlov's dogs learned to salivate not only at the sight of food, but also when exposed to bright light, obese people, through classical conditioning, accept food as a learned response triggered by the mere presence of certain external or internal stimuli. Examples of external stimuli that trigger the need to eat: Environmental factors - availability of food, the smell of food, passing by a store with your favorite food, TV, books, coffee, etc.; Social - holidays, receptions, parties, watching others eat etc. Examples of internal stimuli that cause the need to eat: Physiological - hunger, fatigue, physical discomfort, hormonal changes; Cognitive - wrong thoughts (after breaking a diet - “I’m useless, this doesn’t make sense, I’ll start tomorrow ", influence of advertising, etc.); Emotions - depression, anxiety, social isolation, stressful situations, conflicts, increased comfort, calmness, etc. =============== ===================================================== 2. Operant conditioning. In accordance with this model, methods have been created that are based on the relationship between a reaction and a consequence. Operant conditioning: stimulus -> response - consequence (reward or punishment). The goal is a systematic modification of behavior through manipulation with certain consequences - reward or punishment. Only those changes that are positively reinforced (rewarded) in some way will persist, and those for which there will be punishment will disappear. As a result of conditioning, an obese patient will learn, for example, to eat when it is necessary to make a decision in a stressful situation. At the same time, tension can be reduced, thereby reinforcing inappropriate behavior. On the contrary, if strict diets, insufficient physical activity, unrealistic intentions are followed, unpleasant sensations, punishments, that is, aversive (negative) consequences will follow, and avoidant behavior will be operantly reinforced, and new created the behavior will disappear. The goal of therapy is therefore to make the change in eating and physical behavior enjoyable for obese people, so that the consequences of this change are reflected in an improved quality of life. Only in this way can new habits be maintained long-term, and the reduced weight remain permanent.==================================== =============================================3. Cognitive theory. The third model involves cognitive factors, such as the perceptual and thinking processes of a losing weight individual. Cognitive theory: stimulus -> cognitive work with stimuli - emotional reaction + behavior. Cognitive processes are another factor that can cause inappropriate behavior (for example, black and white thinking influences the fact that an individual adheres to the wrong diet or overeats, different interpretations of the same weight can influence behavior in a positive or negative direction, etc.). (note: owe talked about cognitive models in one of the previous articles, see the link at the end of this article). Cognitive theories suggest that cognitive processes perform a mediating function between stimulus and response. Thus, it is not the stimulus itself that causes a certain behavior, but the meaning that a person attributes this incentive. Learning can take place without direct reinforcement, and also only through cognitive processes. ==================================== ==============================Systematic approach to a person suffering from obesity. Most weight loss therapies focus only on dietary changes, which can cause failure to maintain lost pounds. When losing weight, it is not enough to focus only on changing your diet, you need to influence the thoughts and emotions that lead to unwanted behavior. Treatment of obesity must be comprehensive and concern not only behavior, but also other components according to the following model: An integrated approach assumes that each of the above components affects other areas, and at the same time, changes in these areas affect these components. The first mistake that leads to common failure is setting unrealistic goals and choosing inappropriate methods for weight loss. After the natural and inevitable failure of an unpleasant method of weight loss (for example, strict diets or improper physical activity) appears, the automatic thought: “Again I have failed in my goal.” , I’m a weak-willed person, I’m not capable of anything...” Negative thoughts affect emotions. An overweight person experiences a feeling of hopelessness, sadness, leading to an impact on behavior - an obese patient loses complete control of himself, seeks comfort in food and sets unrealistic goals for further weight loss. This vicious circle is repeated in cycles of varying durations and takes away too much energy from patients, which they could use much more meaningfully. Thus, if cognition plays a significant role in the creation and maintenance of obesity, then it is necessary to focus on cognitive therapy. If emotions play a major role - eating as a reaction to stress, etc., we will use relaxation and other methods. We use behavioral methods to change eating and physical habits. At whatever level we start the change, we Thus, we will influence other aspects of the personality. It is best to influence holistically, on all aspects of the personality. In general, it can be summarized that behavior, thinking and emotions can be anticipated, managed and controlled by systematically influencing the stimuli that excite inappropriate behavior. Also, it is necessary to systematically deal with the consequences of behavior. Thanks to the successes achieved, which consist not only in weight loss, but also in improved physical and mental health and an improved quality of life in general, the patient's behavior is reinforced and maintained in the long term. At the end of therapy, the obese patient should be aware of ways to manage his problem. The patient becomes his own therapist and, in the event of a relapse, he knows how to deal with the problem behavior on his own. More details about the methods of therapeutic effects in subsequent articles. ======================================================= ========================Links to my other articles on the topic of obesity: You can learn about the etiological causes of obesity at this link About clinical manifestations and diagnosis at this link About the connection between obesity with eating disorders and destructive patterns of weight loss at this link About destructive behavioral habits of obesity at this link About cognitive errors and the cognitive model of obesity at this link About interpersonal factors of obesity at this link The article was written using materials from the book “Cognitive-behavioral therapy of mental disorders” Prashko, Mozhny]