The Psychology of Eating: From Healthy to Disordered Behavior

Obesity Treatment 183

Contemporary specific approaches

Over recent years, a multitude of different diets have been developed
which aim to change specific aspects of the diet. For example, some change
the fat–carbohydrate ratio, others encourage dieters to use a point system
whereby foods are worth different points, whilst others recommend the intake
of specific food such as fish or fruit or the use of very low-calories diets.
Some research has evaluated the effectiveness of these different approaches.
For example, low-fat and high-carbohydrate diets have been shown to be
more effective than low-calorie diets for shorter term weight loss, particularly
in heavier subjects (Astrup et al., 2000; Saris et al., 2000), and very low-
calorie diets have been shown to be of some use in the short term for the
severely obese (Wadden, Van Itallie, and Blackburn, 1990). Furthermore,
commercial weight loss programs such as the Atkins diet, Weight Watchers,
Rosemary Conley’s plan, and the meal replacement plan Slim Fast result
in significant (but equal) weight loss (mean 5.9 kg) over 6 months (Truby
et al., 2006). Thorsdottir et al. (2007) evaluated the impact of including
seafood and fish into energy-restricted diets and reported that young
overweight men who included any form of fish or seafood in their diet lost
1 kg more weight at the end of 4 weeks compared to those on a similar
diet without fish. There has also been an interest in diets which promote
the intake of foods with a low glycemic index such as brown bread, pasta,
and rice rather than the white versions of these foods. Using a crossover
design Aston, Stokes, and Jebb (2008) evaluated the impact of low- and
high-GI foods on overweight or obese women and reported no differences
in terms of energy intake, body weight, or ratings of hunger between the
different diets. However, whether any of the weight losses achieved by any
of these specific diets is maintained has yet to be confirmed.

Multidimensional behavioral programs

The failure of traditional treatment packages for obesity resulted in increases
in treatment length, an emphasis on follow-up, and the introduction of a
multidimensional perspective to obesity treatment. Recent comprehensive,
multidimensional cognitive behavioral packages aim to broaden the per-
spective for obesity treatment and combine traditional self-monitoring
methods with nutritional information, exercise, cognitive restructuring,
attitude change, and relapse prevention (e.g., Brownell, 1990, 1999; see
chapter 7 for a discussion of the impact of cue exposure in dieters).