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Obesity: Third Wave Case Conceptualization
Book chapter

Obesity: Third Wave Case Conceptualization

Christina Chwyl, Margaret Sala and Evan M. Forman
Behavior Therapy, pp 437-462
18 Oct 2022
DOI: https://doi.org/10.1007/978-3-031-11677-3_19

Abstract

Acceptance-based behavioral treatment Mindfulness Third wave cognitive behavior therapy for obesity Third wave treatment for obesity Weight loss
Third Wave treatments for obesity propose that standard cognitive and behavioral strategies for obesity are necessary yet insufficient, given the unprecedented challenge of our biological predispositions combined with the modern-day environment. In particular, our biological predispositions (to prefer high calorie foods and conserve energy) and modern environment (in which highly palatable calorie-dense foods are ubiquitous and the need for physical activity is low) are proposed to inevitably give rise to a host of challenging thoughts, feelings, and sensations (e.g., cravings and urges) that require special psychological skills to manage. Given the hyperpalatability of foods in the modern-day environment, difficulties being mindful while eating and being in tune with one’s hunger, taste satisfaction, and satiety cues, may lead individuals to eat based upon immediate desires rather than true biological hunger, thus fueling overeating. Third Wave treatments for obesity provide individuals with mindfulness- and/or acceptance-based strategies for managing the challenges of both external cues (e.g., the presence of delicious foods) and internal cues (e.g., cravings to eat fatty foods). In so doing, these treatments help individuals intentionally choose behaviors in line with biological hunger signals, goals, or values, even amidst such challenges. This chapter presents the theoretical framework for Third Wave treatments for obesity, provides a description of the treatments, and offers suggestions for future research. We review two primary types of treatments: (1) mindfulness-based interventions, which focus on cultivating mindfulness in daily life and eating through meditation and mindfulness practices; and (2) acceptance-based behavioral treatments, which supplement traditional behavioral and cognitive lifestyle modification strategies with mindfulness- and acceptance-based strategies. Third Wave treatments for obesity provide theoretical and applied contributions to the field by incorporating novel applications of acceptance- and mindfulness-based strategies, and by offering viable alternative treatment approaches for individuals with overweight. Yet, little is still known about how to produce enduring weight loss, emphasizing the need for an improved understanding of active treatment ingredients, contextual factors, and the mechanisms underlying effects.

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