Motivational Interviewing for Severe Obesity
In this chapter, we provide an overview of motivational interviewing (MI) and the rationale for integrating it into the management of severe obesity. We then review the empirical evidence supporting the effectiveness of MI in both paediatric and adult pop
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Marlene Taube-Schiff, Lauren David, and Stephanie E. Cassin
Case Vignette
Mr. Davis is a 52-year-old married accountant with two teenaged children. He has been speaking with his family physician for several months about making changes to his dietary habits. In terms of weight history, he reported struggling with weight management issues for as long as he can remember. He comes from a family of five siblings, all of whom have experienced issues with obesity. Mr. Davis has indicated that family gatherings are often cen-
M. Taube-Schiff, Ph.D., C.Psych. (*) Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5 Department of Psychiatry, University of Toronto, Toronto, ON, Canada e-mail: [email protected] L. David Department of Psychology, Ryerson University, Toronto, ON, Canada S.E. Cassin, Ph.D., C.Psych. Department of Psychology, Ryerson University, Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada
tred on food and that cooking has been considered a way to show love for one another. Growing up, he remembered being bullied at school for struggling in gym and being the largest one in his class. As he became older, Mr. Davis continued to struggle with his weight and described that his eating frequently became “out of control”. Mr. Davis reported that food has always been his “go-to” coping strategy and that he turns to food when feeling sad, frustrated, or bored. A typical example would be using food to provide relief after a stressful day at work. He reported that he has always found food to be comforting, and stated that nothing else has enabled him to feel “instantly calm” in the way food has. Furthermore, Mr. Davis endorsed a lengthy history of binge eating and often dissociates when he binges. Since his 20s, Mr. Davis has had a string of weight loss attempts, including fad diets, group-oriented weight-loss programmes, and individual nutritional counselling. He described making necessary dietary changes early on in these programmes, including eating smaller portions and making healthier food choices. Once he was able to lose 80 lbs. However, after 6 months,
Centre for Mental Health, University Health Network, Toronto, ON, Canada © Springer International Publishing AG 2017 S. Sockalingam, R. Hawa (eds.), Psychiatric Care in Severe Obesity, DOI 10.1007/978-3-319-42536-8_16
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(continued) Mr. Davis reported that his cravings would come back and he would gain the weight he had lost, and then some. He believed this pattern of weight loss and weight regain was inevitable for him. As a result, he was left feeling hopeless about taking control of his weight and reluctant to try out any possible strategies. Further, at 350 lbs, Mr. Davis thought he had too much weight to lose. He would often tell his family physician that he was tired of being “set up for failure” when it comes to his eating. Currently, his family physician is feeling quite stuck and does not know what types of interventio
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