MANAGEMENT OF

OBESITY & MUS

 LEARNING OBJECTIVES

• Motivational interviewing and management plan for pts with

obesity and diabetes to loose weight.
• Describe MUS.
• Association of psychosocial factors with MUS.
• Management of MUS according to BPS model.
• Role of CBT.
MOTIVATIONAL INTERVIEWING AND
MANAGEMENT PLAN FOR PTS WITH
OBESITY AND DIABETES TO LOOSE
WEIGHT
 MOTIVATIONAL INTERVIEWING

• “Motivational Interviewing” (MI) as a way of communicating

trust between two people involved in a conversation.
• O'Neill says the five pillars of MI are autonomy, acceptance,
adaptation, empathy, and evocation (calling forth).
 5 STEPS

1.Acceptance facilitates change:

express acceptance, not agreement. ...
2.Awareness of consequences is important:
elicit the patient's concerns. ..
3.Resistance is a signal to change strategies. ...
4.Use momentum to your advantage. ...
5.Belief that change is possible is an important motivator. ..
 THREE MAIN TECHNIQUES USED IN
MOTIVATIONAL INTERVIEWING
• The “OARS” acronym highlights four essential aspects of
motivational interviewing.
1. Ask open-ended questions instead of “yes” or “no”
questions. ...
2. Offer affirmations. ...
3. Practice reflective listening. ...
4. Summarize the visit.
MANAGEMENT PLAN FOR PTS. WITH OBESITY
AND DIABETES TO LOOSE WEIGHT

The best way to treat obesity and diabetes are,

• healthy eating behaviors,
• reduced-calorie diet,
• regular physical activity,
• and reduced sedentary activity.
TOP FIVE WAYS TO FIGHT OBESITY AND DIABETES;

• Focus on the nutritional content of your food. Obesity can be

caused by a poor nutritional diet. ...
• Avoid unhealthy and sugar laden drinks. Many soft and
alcoholic drinks are high in sugar. ...
• Get active. ...
• Learn about and understand your eating habits. ...
• Obesity treatment.
MEDICALLY UNDESCRIBED
SYMPTOMS
 MUS

• Defined as subjective patient symptoms for which the treating

physician, other healthcare providers, and research scientists
have found no medical cause.
 FEATURES

• Persistent bodily complaints for which adequate examination

does not reveal sufficiently explanatory structural or other
specified pathology.
• Physical symptoms without medical explanation.
• Frequent medical visits.
• Frequent lab investigations that yield no unusual findings.
• Symptoms of anxiety and depression common.
 ASSOCIATION OF PSYCHOSOCIAL
FACTORS WITH MUS
• Social support.
• Loneliness.
• Marriage status.
• Social disruption.
• Bereavement.
• Work environment.
• Social status.
• Social integration.
 SOCIAL FACTORS

• Illness perception.
• Illness beliefs (health literacy, stigma).
• Illness behavior.
• Health anxiety
 PSYCHOLOGICAL FACTORS

• Having anxiety or depression.

• Having a medical condition or recovering from one.
• Being at risk of developing a medical condition, such as
having a strong family history of a disease.
• Experiencing stressful life events, trauma or violence.
 EATING DISORDERS

• Anorexia Nervosa

food avoidance, underweight , distorted body weight

• Bulimia Nervosa

Binge eating and purging , normal body weight

 WHAT İS ANOREXİA AND
BULİMİA?
ANOREXİA NERVOSA:
• Anorexia nervosa is one type of
eating disorder. More importantly,
it is also a psychological disorder.
Anorexia is a condition that goes
beyond concern about obesity or
out-of-control dieting.

• People with anorexia have a real

fear of weighting gain and a
distorted view of their body size
and shape. As a result, they can't
maintain a normal body weight.
WHAT İS ANOREXİA AND BULİMİA?

BULİMİA NERVOSA:

Bulimia is similar to anorexia. With bulimia,

someone might binge eat (eat to excess) and
then try to compensate in extreme ways, such
as forced vomiting or excessive exercise, to
prevent weight gain, or using laxatives..

Although anorexia and bulimia are very

similar, people with anorexia are usually
very thin and underweight but those with
bulimia may be a normal weight or can be
overweight.
WHY WOULD A PERSON
BINGE?
■ To fill a void inside
■ To hide negative emotions
■ To cope with daily stresses and
problems

WHY WOULD A PERSON

PURGE?
■ Because of guilt and depression of
having binged .
CAUSES OF ANOREXİA AND BULİMİA
 MANAGEMENT OF MUS ACCORDING
TO BPS MODEL
• Provide Informational care.
• Counseling.
• CBT.
• Medication.
• Psychological interventions;
 Cognitive behavior therapy (CBT).
 Mindfulness-based interventions.
 Acceptance and commitment therapy.
 Relaxation therapy.
 ROLE OF CBT

• CBT uses problem solving techniques to help you understand

and manage your symptoms, as well as working through how
mental health conditions such as anxiety and depression could
be causing your physical complaints.
 3 MAIN GOALS

1. Establishing problem-solving skills.

2. Adapting and adjusting negative thinking habits.
3. Getting back to a daily routine.
COGNITIVE BEHAVIORAL THERAPY

“CBT explores an individual's emotions, thoughts,

attitudes, and beliefs”
seven main stages of CBT for weight management:
1. Self-Monitoring: Begin by keeping track of your eating habits, physical activity, and
emotions related to food. This awareness helps identify patterns and triggers.
2. Stimulus Control: Modify your environment to reduce cues that lead to overeating.
For example, avoid keeping unhealthy snacks visible or accessible.
3. Eating Control: Learn mindful eating techniques. Eat slowly, savor each bite, and
pay attention to hunger and fullness cues. Avoid emotional eating.
4. Reinforcement and Empowerment: Celebrate small victories and give yourself
credit for progress. Positive reinforcement strengthens healthy behaviors.
5.Cognitive Restructuring: Challenge negative thoughts related to food
and weight. Replace them with more helpful, balanced thoughts. For
instance, instead of thinking, “I deserve to eat because I’m stressed,”
consider alternatives like, “I deserve to feel better, and my health goals
matter.”
6.Proper Nutrition Education: Understand the nutritional value of
different foods. Make informed choices based on your health and weight
loss goals.
7.Increasing Physical Activity and Behavioral Contract: Gradually
incorporate exercise into your routine. Create a behavioral contract with
specific goals and rewards.
Remember, CBT teaches us that our thoughts significantly influence our
behavior.
By changing your thinking patterns, you can build habits that support yo
ur weight loss journey and overall well-being
1
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