210 Obesity Treatment
and physical health benefits. Alternative treatment approaches including
exercise, drugs, and surgery are now recommended. Exercise adds nothing
for short-term weight loss but aids longer term weight maintenance. Exercise
also has a direct influence on physical and psychological health regardless
of weight change. Drug therapy can bring about weight loss and even weight
maintenance and may work by encouraging a behavioral model of obesity,
but is accompanied by side effects, and the weight loss can be followed by
weight regain. Surgery has recently been shown to be effective for both weight
loss and maintenance, particularly for those individuals who have failed using
other methods. It can also bring with it a sense of being more in control.
Those who show long-term weight loss and maintenance, however, still
remain in the minority. But this minority provides some insights into
successful dieting, and the research indicates that it is not only what people
do that is important but also what they think, with a psychological model
of obesity in terms of both causes and consequences being associated with
success. Further, research also indicates that some people can use life events
as an opportunity to change, with sustained changes in eating behavior
following negative events which can be reconcepualized as chances for
reinvention. The prevention of obesity in terms of public health and indi-
vidualistic approaches has also been explored. A prevention perspective is
still in its infancy, and although recommendations can be made, the effec-
tiveness of any preventive intervention remains relatively unexplored.
Towards an integrated model of diet
Choosing healthy food is complicated due to the complex mean-
ings associated with food and body size. These meanings can result
in weight concern, which has implications for eating behavior
problems, as dieting can cause overeating and a preoccupation with
food. Another problem associated with eating is obesity. Obesity is
linked to a strong genetic tendency to gain weight, but it is also asso-
ciated with activity levels and food intake. Treatment interventions
therefore emphasize a need to change an individual’s behavior.
Eating behavior is also linked to the problems of anorexia and bulimia.
These are the focus of the next chapter.