Treatment of Childhood & Adolescent Obesity: Expert Recommendations & the Emergence of Immersion & Healthy Obsessions

Treatment of Childhood & Adolescent Obesity: Expert Recommendations & the Emergence of Immersion & Healthy ObsessionsDaniel Kirschenbaum, Ph.D., ABPP

04/15/23 RiverMend Health, LLC 2

Explanations for Immersion-CBT’s Effectiveness

2007 Healthcare Organizations’Four Stage Model

ExpertRecommendations

Self-help Groups

ClientBehaviors& Biology

OVERWEIGHT

OutpatientCognitive-Behavior

Therapy (CBT)

Bariatric Surgery

Immersion CBT

Healthcare Providers:Medical Management,Education & Referral

Specialists:

ExpertRecommendations

Specialists:

Self-help Groups

ClientBehaviors& Biology

OVERWEIGHT

OutpatientCognitive-Behavior

Therapy (CBT)

Bariatric Surgery

Immersion CBT

Healthcare Providers:Medical Management,Education & Referral

ExpertRecommendations

Specialists:

Self-help Groups

ClientBehaviors& Biology

OVERWEIGHT

OutpatientCognitive-Behavior

Therapy (CBT)

Bariatric Surgery

Immersion CBT

Healthcare Providers:Medical Management,Education & Referral

Specialists:

ExpertRecommendations

Specialists:

Self-help Groups

ClientBehaviors& Biology

OVERWEIGHT

OutpatientCognitive-Behavior

Therapy (CBT)

Bariatric Surgery

Immersion CBT

Healthcare Providers:Medical Management,Education & Referral

• ALL endorsed intensive CBT• 2 most recent: de-emphasized EDUCATION• Step models seem best, most inclusive – and emphasis on sustained efforts for > outcomes

Specialists:

• ALL endorsed intensive CBT• 2 most recent: de-emphasized EDUCATION• Step models seem best, most inclusive – and emphasis on sustained efforts for >

outcomes

Explanations for Immersion-CBT’s Effectiveness

Per

cen

t O

verw

eig

ht

Treatment Begins

+10

-20

0

-10

-30

Follow-up

Education & Controls

OutpatientCognitive-Behavior

Therapy (CBT)

ImmersionNon-CBT

ImmersionCBT

From Kelly & Kirschenbaum (2011). Obesity Reviews.

• Obesogenic Environment: Removed

• Greater Intensity: Therapy, Education

• Increased Power: More Modeling & Support

• Momentum: Faster, More Dramatic > Motivation

• Family Support – Increased (momentum again)

Obesogenic Environment: Removed

Greater Intensity: Therapy, Education

Increased Power: More Modeling & Support

Momentum: Faster, More Dramatic > Motivation

Family Support – Increased (momentum again)

Lifestyle ChangeHealthy

Obsession

Rapid Consistent

Weight Loss

Cognitive-Behavior Therapy

Immersion Treatment

Social Support