The obesity epidemic has been recognized in the professional and lay public as a major health problem in the United States and many other cultures. The gastroenterology literature has recently paid attention to this problem, focusing primarily on either physiological mechanisms of obesity or surgical remedies for obesity. However, behavioral strategies developed from social learning theory have been the most thoroughly tested interventions for the treatment of obesity, as well as the interventions shown most clearly to have clinical benefit. Nevertheless, descriptions of behavioral techniques and their theoretical underpinnings have been minimal in the gastroenterology literature. Here, a brief history and presentation of the theoretical underpinnings of behavioral strategies for obesity management is summarized, emphasizing some of the key components, treatment effectiveness data, and needed areas for further research. Overall, it is concluded that behavior therapy is both the most studied and most effective therapy for treating obesity at present. Gastroenterologists are encouraged to use it as a first line of treatment for most obese patients, and as a key component of therapies that involve pharmacologic and surgical components.
1The University of Washington, Seattle, Washington; 2Indiana University School of Medicine, Indianapolis, Indiana; 3The Mayo Clinic College of Medicine, Scottsdale, Arizona, and Rochester, Minnesota; and 4The University of Minnesota, Minneapolis, Minnesota
Reprint requests and correspondence: Rona L. Levy, M.S.W., Ph.D., M.P.H., F.A.C.G., University of Washington, Mailstop 354900, Seattle, WA 98105.
CONFLICT OF INTEREST Guarantor of the article: Dr. Rona Levy.
Specific author contributions: All authors contributed to the conceptualization, preparation, and editing of the manuscript, with lead responsibility by Dr. Rona Levy and Ms. Emily Finch.
Financial support: This paper was supported in part by NIH grant R01 DK064596 awarded to Dr. Robert Jeffery.
Potential competing interests: None.
Received December 20, 2006; accepted April 10, 2007.